• 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
    • Pulm- Dyspnea/hypoxia 
    • 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
  Prognosis:
  • FISH analysis showing deletions on 1/3 and in conjunction with 5/7 offer very poor prognosis
  
  

  Posted 08/01/16 05:03:11 PM by Adam Faye

• For further reading...

  AML Overview
  Genomic Classification and Prognosis in AML
  
  

  Posted 08/01/16 05:03:30 PM by Adam Faye

Created by Christopher Kelly

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