Introduction

Acute myeloid leukaemia is the more common form of acute leukaemia in adults. It may occur as a primary disease or following a secondary transformation of a myeloproliferative disorder.

Classification

Classification - French-American-British (FAB)
  • MO - undifferentiated
  • M1 - without maturation
  • M2 - with granulocytic maturation
  • M3 - acute promyelocytic
  • M4 - granulocytic and monocytic maturation
  • M5 - monocytic
  • M6 - erythroleukaemia
  • M7 - megakaryoblastic

Acute promyelocytic leukaemia M3
  • associated with t(15;17)
  • fusion of PML and RAR-alpha genes
  • presents younger than other types of AML (average = 25 years old)
  • Auer rods (seen with myeloperoxidase stain)
  • DIC or thrombocytopenia often at presentation
  • good prognosis

Epidemiology

  • Incidence: 5.00 cases per 100,000 person-years
  • Peak incidence: 70+ years
  • Sex ratio: more common in males 1.3:1
Condition Relative
incidence
Acute myeloid leukaemia1
Myelodysplastic syndrome0.60
<1 1-5 6+ 16+ 30+ 40+ 50+ 60+ 70+ 80+

Clinical features

Features are largely related to bone marrow failure:

Prognosis

Poor prognostic features
  • > 60 years
  • > 20% blasts after first course of chemo
  • cytogenetics: deletions of chromosome 5 or 7