ACUTE LEUKEMIA : INTRODUCTION Tuesday, March6, 2018 9:21 PM = Characterized by the presence of blasts and immature leukocytes in the peripheral blood and bone marrow + Anemia is usually present. + Can be caused by bleeding and the replacement of normal marrow elements by leukemic blasts. + Total Leukocyte is usually elevated. + Thrombocytopenia is usually present. = TYPES + ACUTE MYELOGENOUS / MYELOID LEUKEMIA = AML Associated with an internal tandem duplication of FLT3 gene predicts inferior outcome + ACUTE LYMPHOCYTIC LEUKEMIA + Progenitor CD34 and P-Glycoprotein if expressed predicts an inferior outcome. ‘THE FRENCH-AMERICAN BRITISH CLASSIFICATION OF LEUKEMIA AND THE WHO CATEGORIES OF LEUKEMIA + ACUTE MYELOGENOUS LEUKEMIA FAB WHO ‘AGE GROUP M:F SURVIVAL MO AML NOT OTHERWISE CATEGORIZED Mi — AMLWITHOUTMATURATION —< 18 yrs old 1:1 35 months after x M2 AML WITH MATURATION Middle aged (around 1.6:1 85 months 48) M3 ACUTE PROMYELOCYTIC Around 38 yrs 2:1 16months LEUKEMIA M4 ACUTEMYELOMONOCYTIC-—OldertthanSO yrs. «14:1 8 months LEUKEMIA, MSa ACUTE MONOBLASTIC Young adults (16 yrs) 0.7:1 LEUKEMIA MSb ACUTE MONOCYTIC LEUKEMIA Middle Age (49 yrs) 1.8:1 M6 —_ ACUTE ERYTHROCYTIC 54 yrs 14:1 11 months LEUKEMIA M7 ACUTE MEGAKARYOBLASTIC ~ poor LEUKEMIA, prognosis-- + ACUTE LYMPHOBLASTIC LEUKEMIA + L1and L2 In WHO CATEGORY = Precursor B Lymphoblastic Leukemia | PRECURSOR 8-CELL ALL = Precursor T Lymphoblastic Leukemia | Precursor T-Cell ALLL FAB Blast Size | Nuclear Shape Nucles cytoplasm 1 Small Indistinet Scant Invisible 12 Large Hetero Indented prominent Abundant large Moderately clefted 13 Large Regular Oval to round Prominent Basophilic Prominent, vacuoles