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⛔⚠ APML, Acute Promyelocytic Leukaemia⚠⛔

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⛔⚠ APML, Acute Promyelocytic Leukaemia⚠⛔

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⛔MEDICAL EMERGENCY; as it is associated with

1. High incidence of DIC

2. Spontaneous bleeding into vital organs

**translocation in Chromosome (15, 17)

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1. Bone marrow failure

2. Frequent infection, thrombocytopenia & anaemia

3. Gum hypertrophy

4. CNS effects, ie, headache and diplopia but less likely compared to ALL

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Lists of recurrent genetic abnormalities in AML 

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Lists of recurrent genetic abnormalities in AML 

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1. Median onser: 65 y/o

2. Genetic factors ie; DOWNS SYNDROME

3. Environmental exposures; Radiation, Chemotherapy, Benzene

4. Has underlying haemopoietic neoplasms; ie: Myelodysplasia, Myeloproliferative neoplasms.

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Weight loss, fever, malaise, fever, chills, night sweats

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Weight loss, fever, malaise, fever, chills, night sweats

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IE; Uric acid, K+, LDH into plasma

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⚠⛔ DISSEMINATED INTRAVASCULAR COAGULATION (DIC) ⚠⛔

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⚠⛔ DISSEMINATED INTRAVASCULAR COAGULATION (DIC) ⚠⛔

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May cause LEUKOCYTOSIS despite pancytopenia

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May cause LEUKOCYTOSIS despite pancytopenia

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Myeloid cells normally produce intracellular granules, which precipitate inside immature blasts to form rods

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Myeloid cells normally produce intracellular granules, which precipitate inside immature blasts to form rods

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Neoplastic blasts secrete excessive amounts of coagulation-promoting cytokines into circulation

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Neoplastic blasts secrete excessive amounts of coagulation-promoting cytokines into circulation

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on bone marrow aspirate/ biopsy

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Multifactorial causes , most with unclear mechanisms

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Multifactorial causes , most with unclear mechanisms

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High turnover of the neoplastic blastic cells

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High turnover of the neoplastic blastic cells

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After the neoplastic blasts fill up the bone marrow, they spill out into the blood

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After the neoplastic blasts fill up the bone marrow, they spill out into the blood

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Abundant blasts displacing other blood cell precursors in the marrow, inhibiting their development

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Abundant blasts displacing other blood cell precursors in the marrow, inhibiting their development

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Neoplastic myeloid precursor cells (blasts) divide & accumulate in the bone marrow

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Neoplastic myeloid precursor cells (blasts) divide & accumulate in the bone marrow

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Accumulation of genetic abnormalities in the original myeloid precursor cells (blast)

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Accumulation of genetic abnormalities in the original myeloid precursor cells (blast)