|
Images of Different Types of AML |
||
|---|---|---|
| Classification of AML*[1,2] | ||||||||
|---|---|---|---|---|---|---|---|---|
| Subtype | FAB | Freq |
Morphology | MP | SE | NSE |
Immune Markers | Cytogenetic Abnormalities |
Acute myeloblastic leukemia |
M0 |
2 |
No azurophil granules |
- |
- |
- |
MY7(CD13) |
- |
Acute myeloblastic leukemia |
M1 |
19 |
A few azurophilic granules |
+/- |
+/- |
- |
MY7 (CD13) |
del(5) |
AML, with differentiation |
M2 |
24 |
Some maturation beyond |
++ |
++ |
- |
MY7 |
t(8;21) |
Acute promyelocytic leukemia |
M3 |
10 |
Hypergranular promyelocytes; |
+++ |
+++ |
- |
MY7 |
t(15;17) |
Acute myelomonocytic |
M4 |
30 |
>=20% monocytes; |
++ |
++ |
++ |
MY4(CD14) |
inv(16) |
Acute monocytic leukemia |
M5 |
10 |
Monoblastic (M5A) |
-/+ |
- |
+++ |
MO1 |
t(9;11) |
Acute erythroleukemia |
M6 |
4 |
Predominance of erythroblasts; |
- |
- |
- |
Glycophorin A |
- |
Acute megakaryocytic |
M7 |
1 |
"Dry" aspirate; biopsy |
- |
- |
- |
gpIIb/IIIa (CD41a) |
- |
| *Findings may be somewhat variable. **In adults. ***IDAMYCIN is not indicated for use in AML FAB M0. Anti-MPO+ (or EM peroxidase +). Abbreviations: MP, myeloperoxidase; SE, specific esterase (chloracetate); NSE, nonspecific esterase (naphthylbutyrate). |
||||||||
| Prognostic Factors in AML[3,4] | |||
|---|---|---|---|
| Factor | Favorable | Unfavorable | |
| Clinical | Age |
< 45 years |
< 2 years, > 60 years |
Leukemia |
De novo |
Preceding myelodysplasia |
|
Leukocytosis |
< 25,000/mm³ |
> 100,000/mm³ |
|
Complete remission |
Long duration |
Short duration |
|
Central nervous system |
Absent |
Present |
|
Cytoreduction |
Rapid |
Delayed | |
| Morphology | Auer rods |
Present |
Absent |
Eosinophils |
Present |
Absent |
|
Dysplastic morphology |
Absent |
Present |
|
FAB type |
M2, M3, M4 |
M0, M1, M5, M6, M7 |
|
| Surface/Enzyme Markers | Myeloid |
- |
CD34+ |
HLA-DR |
Negative |
Positive |
|
TdT |
Absent |
Present (weak correlation) |
|
Lymphoid |
CD2+ or CD19+ |
Biphenotypic |
|
Peroxidase |
High score (FABM1) |
Low score (FAB M1) |
|
Cytogenetics |
t(15;17),t(8;21), |
-7,del(7q);-5;3q or 11q23 |
|