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Lecture3b-AML

Lecture3b-AML

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Published by: j.doe.hex_87 on May 20, 2010
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12/14/2013

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Acute Myelogenous Leukemia
DEFINITION. Acute myelogenous leukemia (AML) is a
malignant disease of the bone marrow in which hematopoietic
precursors are arrested in an early stage of development.
BLASTS in b.m.: >20%
PATHOPHYSIOLOGY
AML=maturational arrest of bone marrow cells in the earliest
stages of development.
CONSEQUENTLY: 2 disease processes:
-First, the production of normal blood cells markedlydecreases,
which results in varying degrees of anemia, thrombocytopenia, and
neutropenia.
- Second, the rapid proliferation of these cells, along with a reduction
in their ability to undergo programmed cell death (apoptosis), results in
theiraccumulation in the bone marrow, blood, and, frequently, the
spleen and liver.
FREQUENCY: 3/100.000 annually
Acute myelogenous leukemia (AML) is more commonly diagnosed in developed
countries.
RACE
Acute myelogenous leukemia (AML) is more common in whites than in other
populations.
SEX: AML is more common in women .
AGE:The prevalence of acute myelogenous leukemia (AML) increases with age.
ETIOLOGY:
-IDIOPATHIC;
-CAUSES:
1.Antecedent hematologic disorders:
-MDS.
- APLASTIC ANEMIA
-MYELOFIBROSIS
-PAROXYSMAL NOCTURNAL HEMOGLOBINURIA
2. Congenital disorders

-Down syndrome,
-congenital neutropenia,
-Fanconi anemia,
-neurofibromatosis.
-Familial syndromes

3.Environmental exposures :
-IRRADIATION (professional, accidental, therapeutic)

-Persons who smoke have a small but statistically significant (odds ratio, 1.5)
increased risk of developing myelogenous leukemia (AML). In several studies,
the risk of AML was slightly increased in people who smoked compared with
those who did not smoke.

-BENZENE : aplastic anemia and pancytopenia. These patients often develop
AML. Many of these patients demonstrate M6 morphology.
-CHEMOTHERAPY
(3-5 ys or 9-12 months,according to agents)
CLINICAL
-SYMPTOMS RESULT FROM:
1.-BONE MARROW FAILURE:
ANEMIA + NEUTROPENIA + THROMBOCYTOPENIA
ANEMIA + INFECTIONS + HEMORRHAGIA

ANEMIA:
-FATIGUE
-EXERTIONAL DYSPNEA
-DIZINESS
-ANGINAL CHEST PAIN\u2026.MYOCARDIAL INFARCTION

NEUTROPENIA:
-INFECTIONS
\u2026UPPER RESPIRATORY INFECTIONS RESISTANT TO ANTIBIOTICS\u2026

THROMBOCYTOPENIA:
-BLEEDING GUMS
-ECCHYMOSES
-DISSEMINATERD INTRAVASCULAR COAGULATION

2-ORGAN INFILTRATION WITH LEUKEMIC CELLS

-LIVER, SPLEEN, SKIN, GUMS;
-LEUKOSTASIS
-BONE PAIN
-LYMPH NODES ENLARGEMENT

.

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