72 y/o with generalized weakness, fever, found to have acute AML
Dr. Todd Rosenblat | Morning Report | 08/01/2016
In Acute Leukemia- neutrophils are not functioning properly (Thus, even if ANC > 1,500 because of leukocytosis neutrophil function still impaired).
Posted 08/01/16 04:51:16 PM by Adam Faye
Transfusion practices in Acute Leukemia: In acute leukemia likely will have thrombocytopenia/anemia - often important to transfuse. However, be cautious if WBC >50-100,000 with many blasts- can lead to leukostasis and acute decompensation.
Signs and Symptoms
Neuro- Visual changes, HA, dizziness, tinnitus, gait instability, confusion, somnolence
Treat with cytoreduction - chemo/hydrea/leukapheresis (be cautious of precipitating TLS)
Posted 08/01/16 04:57:33 PM by Adam Faye
When treating AML: In those <55, time to chemo has a mortality benefit:
Induction Chemo - Cytarabine with an Anthracycline
If there is an underlying infection you cannot control in acute leukemia you should NOT go ahead with chemotherapy
High Fibrinogen does NOT necessarily r/o DIC
FISH analysis showing deletions on 1/3 and in conjunction with 5/7 offer very poor prognosis