acute vs chronic myeloid leukemia

... (FDA) for marketing based on trials using the FAB criteria. Acute Myeloid Leukemia Incidence The incidence of acute myeloid leukemia (AML) is ~3.7 per 100,000 people per year, and the age-adjusted ... Radiation Survivors of the atomic bomb explosions in Japan had an increased incidence of myeloid leukemias that peaked 5–7 years after exposure. Therapeutic radiation alone seems to add little ... agent–associated leukemias occur on average 4–6 years after exposure, and affected individuals have aberrations in chromosomes 5 and 7. Topoisomerase II inhibitor–associated leukemias occur...

Ngày tải lên: 07/07/2014, 04:20

... Acute myelomonocytic leukemia Acute monoblastic and monocytic leukemia Acute erythroid leukemia Acute megakaryoblastic leukemia Acute basophilic leukemia Acute panmyelosis ... myelofibrosis Myeloid sarcoma French-American-British (FAB) Classification c Incidence M0: Minimally differentiated leukemia 5% M1: Myeloblastic leukemia without maturation 20% M2: Myeloblastic leukemia ... Myelomonocytic leukemia 20% M4Eo: Variant: Increase in abnormal marrow eosinophils M5: Monocytic leukemia 10% M6: Erythroleukemia (DiGuglielmo's disease) 4% M7: Megakaryoblastic leukemia...

Ngày tải lên: 07/07/2014, 04:20

... transducer and Chapter 104. Acute and Chronic Myeloid Leukemia (Part 3) Immunophenotype and Relevance to the WHO Classification The immunophenotype of human leukemia cells can be studied ... diagnosed by flow-cytometric demonstration of the myeloid- specific antigens cluster designation (CD) 13 or 33. Similarly, acute megakaryoblastic leukemia can often be diagnosed only by expression ... specific recurrent genetic abnormalities. For example, AML FAB M3 is now designated acute promyelocytic leukemia (APL), based on the presence of either the t(15;17)(q22;q12) cytogenetic rearrangement...

Ngày tải lên: 07/07/2014, 04:20

... by abnormal lobulation and deficient granulation. Figure 104-1 Chapter 104. Acute and Chronic Myeloid Leukemia (Part 4) Clinical Presentation Symptoms Patients with AML most often ... cells. Abnormal rod-shaped granules called Auer rods are not uniformly present, but when they are, myeloid lineage is virtually certain (Fig 104-1). Poor neutrophil function may be noted by impaired ... leukocyte dysfunction, or thrombocytopenia. Nearly half have had symptoms for ≤3 months before the leukemia was diagnosed. Half mention fatigue as the first symptom, but most complain of fatigue...

Ngày tải lên: 07/07/2014, 04:20

... Chapter 104. Acute and Chronic Myeloid Leukemia (Part 5) Morphology of AML cells. A. Uniform population of primitive ... (leukemic infiltration, most commo n in monocytic leukemia) Skin infiltration or nodules (leukemia infiltration, most common in monocytic leukemia) Lymphadenopathy, splenomegaly, hepatomegaly ... infection. Table 104- 2 Initial Diagnostic Evaluation and Management of Adult Patients with Acute Myeloid Leukemia History Increasing fatigue or decreased exercise tolerance (anemia) Excess...

Ngày tải lên: 07/07/2014, 04:20

... most importantly, achievement of CR. In addition, patients who achieve Chapter 104. Acute and Chronic Myeloid Leukemia (Part 6) Most patients are anemic and thrombocytopenic at presentation. ... the importance of cytogenetic as well as the previously discussed molecular assessment of the leukemia cells at diagnosis and relevance of storing samples for potential later use. A prolonged ... The bone marrow should contain <5% blasts, and Auer rods should be absent. Extramedullary leukemia should not be present. For patients in morphologic CR, reverse transcriptase polymerase...

Ngày tải lên: 07/07/2014, 04:20

... Chapter 104. Acute and Chronic Myeloid Leukemia (Part 7) Acute Myeloid Leukemia: Treatment Treatment of the newly diagnosed patient with ... Figure 104-2 Flow chart for the therapy of newly diagnosed acute myeloid leukemia. For all forms of AML except acute promyelocytic leukemia (APL), standard therapy includes a 7-day continuous ... the CR duration. After induction chemotherapy, the bone marrow is examined to determine if the leukemia has been eliminated. If ≥5% blasts exist with ≥20% cellularity, the patient is usually...

Ngày tải lên: 07/07/2014, 04:20

... Chapter 104. Acute and Chronic Myeloid Leukemia (Part 8) The hematologic toxicity of high-dose cytarabine-based induction...

Ngày tải lên: 07/07/2014, 04:20

... antibodies Yttrium-90-labeled human M195 Chapter 104. Acute and Chronic Myeloid Leukemia (Part 9) Treatment of Promyelocytic Leukemia Tretinoin is an oral drug that induces the differentiation ... autologous SCT. High- dose cytarabine is more effective than standard-dose cytarabine. The Cancer and Leukemia Group B (CALGB), for example, compared the duration of CR in patients randomly assigned...

Ngày tải lên: 07/07/2014, 04:20

... Chapter 104. Acute and Chronic Myeloid Leukemia (Part 11) Chronic Myelogenous Leukemia Incidence The incidence of chronic myelogenous leukemia (CML) is 1.5 per 100,000 ... (named after the abelson murine leukemia virus) gene located on chromosome 9q34. Untreated, the disease is characterized by the inevitable transition from a chronic phase to an accelerated ... compared to 1977–1997. Definition Disease Progression The events associated with transition to the acute phase, a common occurrence in the pre-imatinib era, were extensively studied. Chromosomal...

Ngày tải lên: 07/07/2014, 04:20

... Cycling of the counts may be Chapter 104. Acute and Chronic Myeloid Leukemia (Part 12) Clinical Presentation Symptoms The clinical onset of the chronic phase is generally insidious. Accordingly, ... Blast crisis is defined as acute leukemia, with blood or marrow blasts ≥20%. Hyposegmented neutrophils may appear (Pelger-Huet anomaly). Blast cells can be classified as myeloid, lymphoid, erythroid, ... are elevated. Phagocytic functions are usually normal at diagnosis and remain normal during the chronic phase. Histamine production secondary to basophilia is increased in later stages, causing...

Ngày tải lên: 07/07/2014, 04:20

... GVHD; and (5) posttransplantation treatment. Chapter 104. Acute and Chronic Myeloid Leukemia (Part 13) Chronic Myelogenous Leukemia: Treatment The therapy of CML is changing rapidly because ... cytogenetic, or molecular remission a Nutritional Comprehensive Cancer Network, Chronic myelogenous leukemia. b Denotes that at the indicated milestones, patients should stay on the same...

Ngày tải lên: 07/07/2014, 04:20

... and even syngeneic marrow may exhibit limited GVL activity in CML. Chapter 104. Acute and Chronic Myeloid Leukemia (Part 14) The Patient Patients should have acceptable end-organ function, ... BMT in patients with chronic- phase CML results in 7-year disease-free survival in 55% of patients, with a 30% relapse rate. BMT with an HLA-identical sibling in the chronic phase achieves ... groups, patients receiving BMT from unrelated donors have higher rates of graft failure and acute and chronic GVHD and prolonged convalescence after treatment, compared to those who receive allogeneic...

Ngày tải lên: 07/07/2014, 04:20

... Myelosuppression, while rare, may require holding drug and/or growth Chapter 104. Acute and Chronic Myeloid Leukemia (Part 15) Posttransplantation Treatment BCR/ABL transcript levels have ... treatment goal in CML. Specific milestones have been developed for chronic- phase CML patients (Table 104-4). For example, chronic- phase CML patients who do not achieve any cytogenetic remission...

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