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[[Image:Auer_rods.PNG|thumb|right|Auer rods characterize ''acute myeloid leukemia''.]] | |||
'''Acute myeloid leukemia''', abbreviated '''AML''', is a group of [[cancer|malignancies]]. | |||
=Overview= | |||
*Group of malignancies. | |||
*Defined by the cytogenetic abnormalities. | |||
=No recurrent cytogenetic abnormalities= | |||
==Acute myeloid leukemia without recurrent cytogenetic abnormalities== | |||
===General=== | ===General=== | ||
*Adults. | *Adults. | ||
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*May be classified by morphology, using the (old) French-American-British (FAB) classification (M0-M7). | *May be classified by morphology, using the (old) French-American-British (FAB) classification (M0-M7). | ||
===Image=== | |||
<gallery> | <gallery> | ||
Image:Auer_rods.PNG | Auer rods in an AML. (WC) | Image:Auer_rods.PNG | Auer rods in an AML. (WC) | ||
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*Must exclude all the recurrent cytogenetic abnormalities - see below. | *Must exclude all the recurrent cytogenetic abnormalities - see below. | ||
=AML with recurrent cytogenetic abnormalities= | |||
==Acute myeloid leukemia with t(8;21)== | |||
IHC | ===IHC=== | ||
*CD34+, CD13+, MPO+ (cytoplasm), CD33+ (weak). | *CD34+, CD13+, MPO+ (cytoplasm), CD33+ (weak). | ||
*[[CD56]]+, CD117+. | *[[CD56]]+, CD117+. | ||
**Usu. assoc. with a bad prognosis. | **Usu. assoc. with a bad prognosis. | ||
Flow cytometry | ===Flow cytometry=== | ||
*CD19+, PAX5+, CD79a +/-. | *CD19+, PAX5+, CD79a +/-. | ||
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*[http://path.upmc.edu/cases/case712.html AML with t(8;21) (upmc.edu)]. | *[http://path.upmc.edu/cases/case712.html AML with t(8;21) (upmc.edu)]. | ||
===Acute myeloid leukemia with inv(16) | ===Molecular=== | ||
*t(8;21)(q22;q22).<ref>{{Cite journal | last1 = Berger | first1 = R. | title = Translocation t(8;21)(q22;q22): cytogenetics and molecular biology. | journal = Nouv Rev Fr Hematol | volume = 36 Suppl 1 | issue = | pages = S67-9 | month = | year = 1994 | doi = | PMID = 8177719 }}</ref> | |||
==Acute myeloid leukemia with inv(16)== | |||
*inv(16)(p13.1q22).<ref name=pmid16917916>{{Cite journal | last1 = Lu | first1 = CM. | last2 = Murata-Collins | first2 = JL. | last3 = Wang | first3 = E. | last4 = Siddiqi | first4 = I. | last5 = Lawrence | first5 = HJ. | title = Concurrent acute myeloid leukemia with inv(16)(p13.1q22) and chronic lymphocytic leukemia: molecular evidence of two separate diseases. | journal = Am J Hematol | volume = 81 | issue = 12 | pages = 963-8 | month = Dec | year = 2006 | doi = 10.1002/ajh.20716 | PMID = 16917916 }} | *inv(16)(p13.1q22).<ref name=pmid16917916>{{Cite journal | last1 = Lu | first1 = CM. | last2 = Murata-Collins | first2 = JL. | last3 = Wang | first3 = E. | last4 = Siddiqi | first4 = I. | last5 = Lawrence | first5 = HJ. | title = Concurrent acute myeloid leukemia with inv(16)(p13.1q22) and chronic lymphocytic leukemia: molecular evidence of two separate diseases. | journal = Am J Hematol | volume = 81 | issue = 12 | pages = 963-8 | month = Dec | year = 2006 | doi = 10.1002/ajh.20716 | PMID = 16917916 }} | ||
</ref> | </ref> | ||
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*Associated with [[myeloid sarcoma]]. | *Associated with [[myeloid sarcoma]]. | ||
Microscopic | ===Microscopic=== | ||
*Blast count usu. ~20% (low). | *Blast count usu. ~20% (low). | ||
*Eosinophilic granules. | *Eosinophilic granules. | ||
**Used to be classified as "M4" with eosinophilia. | **Used to be classified as "M4" with eosinophilia. | ||
IHC | ===IHC=== | ||
*CD2+ -- common. | *CD2+ -- common. | ||
==Acute myeloid leukemia with t(15;17)== | |||
*[[AKA]] ''acute promyelocytic leukemia'' | *[[AKA]] ''acute promyelocytic leukemia'' | ||
**Abbreviated ''APL''. | **Abbreviated ''APL''. | ||
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**Fusion transcripts: PML<ref name=omim102578>{{OMIM|102578}}</ref>-RARA.<ref name=omim180240>{{OMIM|180240}}</ref> | **Fusion transcripts: PML<ref name=omim102578>{{OMIM|102578}}</ref>-RARA.<ref name=omim180240>{{OMIM|180240}}</ref> | ||
===General=== | |||
Clinical: | Clinical: | ||
*Associated with [[DIC]]. | *Associated with [[DIC]]. | ||
*Treatment: all-trans retinoic acid (ATRA). | *Treatment: all-trans retinoic acid (ATRA). | ||
===Microscopic=== | |||
Comes in two flavours. | Comes in two flavours. | ||
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*Absence of granules on light microscopy. | *Absence of granules on light microscopy. | ||
====Images==== | |||
<gallery> | <gallery> | ||
Image:Faggot cell in AML-M3.jpg |Faggot cell in AML-M3. (WC) | Image:Faggot cell in AML-M3.jpg |Faggot cell in AML-M3. (WC) | ||
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*[http://path.upmc.edu/cases/case705.html APML - several images (upmc.edu)]. | *[http://path.upmc.edu/cases/case705.html APML - several images (upmc.edu)]. | ||
===IHC=== | |||
*CD2 +ve, CD34 +ve/-ve, CD56 +ve/-ve. | *CD2 +ve, CD34 +ve/-ve, CD56 +ve/-ve. | ||
===[[Flow cytometry]]=== | |||
*CD34 -ve, HLA-DR -ve. | *CD34 -ve, HLA-DR -ve. | ||
*CD33 +ve, CD13 +ve/-ve, CD117 +ve (weak), CD56 +ve/-ve. | *CD33 +ve, CD13 +ve/-ve, CD117 +ve (weak), CD56 +ve/-ve. | ||
=== | ===Molecular=== | ||
*t( | Variants: | ||
*t(11;17) -- ATRA doesn't work.<ref>{{Ref APBR|623 Q2}}</ref> | |||
*t(17;17) -- ATRA doesn't work. | |||
* | *t(5;17). (???) | ||
* | |||
==Acute myeloid leukemia with t(9;11)== | |||
===General=== | |||
Clinical: | Clinical: | ||
*+/-[[DIC]]. | *+/-[[DIC]]. | ||
*Usu. children. | *Usu. children. | ||
IHC | ===Microscopic=== | ||
*Monoblastic morphology. (???) | |||
*Myelomonocytic morphology. (???) | |||
===IHC=== | |||
*CD33+, CD65+, CD4+, HLA-DR+. | *CD33+, CD65+, CD4+, HLA-DR+. | ||
*CD34+. (???) | *CD34+. (???) | ||
*CD13+. (???) | *CD13+. (???) | ||
===Molecular=== | |||
*t(9;11). | |||
=See also= | |||
*[[Leukemia]]. | |||
=References= | |||
{{Reflist|1}} | |||
[[Category: Hematopathology]] | [[Category: Hematopathology]] | ||