Acute Myeloid Leukemia
Acute myeloid leukemia (AML) represents a heterogenous group of disorders that are characterized by peripheral blood and bone marrow myeloblast proliferations that will kill the patient in weeks or months if untreated . They show variable response to therapy, and some types are best treated by hematopoietic cell transplantation, while other types may be eligible for more targeted therapy. The 2016 World Health Organization (WHO) classification of acute myeloid leukemia includes a number of categories and many subtypes . Most of these subtypes have distinctive morphologic features, which are illustrated in this chapter, but the complete diagnosis relies on correlation between morphology, immunophenotypic, cytogenetic, and molecular genetic studies. Although the detection of Auer rods—cytoplasmic granules that aggregate to form rod-shaped cytoplasmic inclusions—is specific for myeloid lineage, they are not present in many cases, and immunophenotyping is now routine in all cases of suspected acute leukemia. Cytochemical studies may also be useful but have been largely supplanted by flow cytometry immunophenotyping. While this chapter focuses on the morphology of the bone marrow in AML, correlation with peripheral blood findings is also essential, and some cases may have more myeloblasts in the blood than in the marrow; such cases may be diagnosed as AML based solely on the peripheral blood blast cell count.
KeywordsLeukemia Acute Myeloid Myelogenous Nonlymphocytic
- 4.Díaz-Beyá M, Rozman M, Pratcorona M, Torrebadell M, Camós M, Aguilar JL, et al. The prognostic value of multilineage dysplasia in de novo acute myeloid leukemia patients with intermediate-risk cytogenetics is dependent on NPM1 mutational status. Blood. 2010;116(26):6147–8.CrossRefPubMedGoogle Scholar
- 9.Lange BJ, Kobrinsky N, Barnard DR, Arthur DC, Buckley JD, Howells WB, et al. Distinctive demography, biology, and outcome of acute myeloid leukemia and myelodysplastic syndrome in children with Down syndrome: Children’s cancer group studies 2861 and 2891. Blood. 1998;91(2):608–15.PubMedGoogle Scholar
- 10.Arber DA, Borowitz MJ, Cessna M, Etzell J, Foucar K, Hasserjian RP, et al. Initial diagnostic workup of acute leukemia: guideline from the College of American Pathologists and the American Society of Hematology. Arch Pathol Lab Med. 2017;141(10):1342–93.Google Scholar