Acute myeloid leukaemia

Published on 03/04/2015 by admin

Filed under Hematology, Oncology and Palliative Medicine

Last modified 03/04/2015

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Acute myeloid leukaemia

Classification

The WHO system has now largely superseded the French-American-British (FAB) classification. The newer classification reduces the bone marrow leukaemic blast cell percentage differentiating AML from myelodysplastic syndrome (see p. 50) from 30% to 20%. Other key changes include the creation of specific subtypes with non-random cytogenetic or equivalent molecular abnormalities, and the distinction of patients with multilineage dysplasia and also previous chemotherapy. The major FAB subtypes are included in the ‘other’ category with the exception of acute promyelocytic leukaemia (previously FAB M3) which is now in the ‘recurrent translocations’ group due to the inevitable presence of t(15;17). It can be seen (Table 20.1) that occasional cases of AML show megakaryocytic or erythroid differentiation. Gene mutations are likely to become increasingly important in classification.