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Acute leukemia Last updated: May 27, 2022
Summary
Epidemiology
Etiology
Classification
Pathophysiology
Clinical features
Diagnostics
Treatment
Complications
Prognosis
5-year survival rate following treatment
ALL: The 5-year survival rate is generally higher compared to AML (varies from ∼ 20% in elderly
patients to ∼ 80% in children and adolescents)
AML: ∼ 30%, but it varies according to the patient's age. The survival time has increased more recently
due to improvements in treatment.
Unfavorable prognostic factors
ALL AML
Age < 1 year or > 10 years > 60 years
Disease WBC count > 50,000/mm3 ↑ LDH
features CNS involvement at diagnosis FAB M7 (acute megakaryocytic leukemia)
Cytogenetics Philadelphia chromosome t(9;22) Various translocations, e.g., t(6;9)
Hypoploidy Karyotype abnormalities (e.g., trisomy 8,
monosomy 5 or 7)
Complex pattern of aberrations (> 3
aberrations) FLT3 gene mutation
Complex pattern of aberrations (i.e., > 3
aberrations)
Immunotyping Mature B-cell ALL CD34
Precursor T-cell ALL MDR1
Favorable prognostic factors
ALL AML
< 50,000/mm3 t(8;21)
No CNS involvement Acute promyelocytic leukemia (APL) with t(15;17)
t(12;21)
Hyperploidy
To remember that translocation t(12;21) commonly manifests with pediatric B-ALL and
usually has a favorable outcome, think: “Kids flip back to health!” (the number 12 is 21
flipped around).
References:[41][42][43][44][45][46]
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References
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