Acute myeloid leukemia

Definition

• Malignant proliferation of myeloblasts

Epidemiology

• 1% of cancer deaths
• Median age 65
• More common in Fanconi's anemia, ataxia-telangiectasia, neurofibromatosis, and Bloom's syndrome due to chromosomal instability

Pathophysiology

• AML with genetic aberrations
  • t(8;21)
  • inv(16)
  • t(15;17)
  • 11q23 abnormalities
• Myelodysplasia-like
• Therapy-related: from 1 to 8 or more years following chemotherapy
• Not otherwise specified
  • AML with myelomonocytic differentiation
  • AML with erythroid maturation

Management

• Induction chemotherapy with "7 + 3" cytarabine and daunorubicin with the goal of remission
• Consolidation chemotherapy with HiDAC
• Allogeneic stem cell transplantation

Prognosis

• Better with younger age (<50), good performance status, lack of other medical comorbidities, no history of prior exposure to cytotoxic agents or radiation therapy, and no history of prior MDS or other hematologic disorder
• Categorized based on cytogenetic and molecular features

Further Reading

• http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/hematology-oncology/acute-myelogenous-leukemia/