Leukemia, Acute Myelogenous

Leukemia, Acute Myelogenous

Sherry L. Bayliff, MD, MPH

Basic Information

Definition

Acute myelogenous leukemia (AML) is the malignant transformation and proliferation of any myeloid progenitor cell.

Synonyms

Acute nonlymphocytic leukemia
AML

ICD-9-CM Code

205.00 Acute myelogenous leukemia

Epidemiology & Demographics

• There are approximately 500 new cases of AML per year, accounting for 20% of cases of pediatric leukemia.
• No sex or ethnic predisposition exists for AML. There is a slight increase in case numbers during the teenage years.
• Most cases of congenital leukemia (i.e., within the first 4 weeks of life) are AML.

Clinical Presentation

History

• Unexplained fever, serious infection or sepsis; pallor, fatigue, weight loss; bruising or bleeding; bone pain; persistent respiratory or gastrointestinal symptoms; “blueberry muffin” rash in neonates.

Physical Examination

• Cutaneous or mucosal hemorrhage, menorrhagia; hepatosplenomegaly, lymphadenopathy; gingival hypertrophy; leukemia cutis (i.e., bluish skin nodules), especially in the neonate; retinal hemorrhage or cotton-wool spots on funduscopic examination.

Etiology

• The cause is unknown.
• Specific genetic abnormalities are present in the leukemia cell, but it is unknown how they arise; myelodysplasia often converts to AML.
• Children with genetic conditions such as trisomy 21 (i.e., Down syndrome) or Fanconi’s anemia are at increased risk.
• Environmental exposures, such as ionizing radiation, benzene, epipodophyllotoxins (i.e., etoposide), and alkylating agents, are associated with AML.

Diagnosis

Differential Diagnosis

• Hematologic disorders: aplastic anemia, idiopathic thrombocytopenic purpura
• Infection or sepsis: disseminated intravascular coagulation (DIC), osteomyelitis

Laboratory Tests

• Complete blood cell count is required; most patients have significant anemia and thrombocytopenia.
image Immature white blood cells (WBCs) (e.g., promyelocytes, myelocytes) are seen on the differential count.

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Jun 19, 2016 | Posted by in PEDIATRICS | Comments Off on Leukemia, Acute Myelogenous

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