Page 204 - Essential Haematology

190 / Chapter 13 Acute myeloid leukaemia

SUMMARY ■ The leukaemias are a group of disorders ■ In younger patients treatment is primarily

characterized by the accumulation of
with the use of intensive chemotherapy.
malignant white cells in the bone marrow
This is usually given in four blocks each of
approximately 1 week using drugs such as
and blood. They can be classifi ed into four

subtypes on the basis of being either acute
cytosine arabinoside and daunorubicin.

■ Acute promyelocytic leukaemia is a variant
or chronic , and myeloid or lymphoid .

■ Acute leukaemias are aggressive diseases
chromosomal translocation. It commonly
in which transformation of a haemopoietic

stem cell leads to accumulation of > 20% of AML that carries a t(15; 17)
presents with bleeding and is treated with
blast cells in the bone marrow. retinoic acid and chemotherapy.
■ The clinical features of acute leukaemia ■ The prognosis for patients with AML has

result from bone marrow failure and been improving steadily, particularly for
include anaemia, infection and bleeding. those under 60 years of age, and
Tissue infi ltration can also occur. approximately one - third of this group can

■ AML is rare in childhood but becomes expect to achieve long - term cure. The

increasingly common with age with a outcome for elderly people remains
median onset of 65 years. disappointing.

■ The diagnosis is made by analysis of ■ Allogeneic stem cell transplantation is

blood and bone marrow using microscopic useful in treating some subsets of patients
examination (morphology) as well as and may also be curative for patients with
immunophenotypic, cytogenetic and relapsed disease.
molecular studies.
■ Cytogenetic and molecular abnormalities

are used to classify and indicate prognosis
in the majority of cases of AML.
Now visit www.wiley.com/go/essentialhaematology
to test yourself on this chapter.