Hematologic malignancies: acute leukemias by Elihu H. Estey, S.H. Faderl, H.M. Kantarjian PDF

By Elihu H. Estey, S.H. Faderl, H.M. Kantarjian

Better treatment of acute leukemias relies eventually on greater figuring out of the excellence among leukemic and common progenitor cells. hence, a number of chapters during this quantity describe present wisdom of acute leukemia biology and speak about new category platforms that experience arisen consequent to rising insights into pathogenesis. therapy has additionally more advantageous for specific sorts of acute leukemia. Given our goal that the ebook be necessary to clinicians, we pay specific recognition to those advances, to administration of acute leukemia usually, and to improvement of latest therapies.

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These settings appear to be iatrogenic models of MDR-AML pathogenesis. 4. 3 The Myelodysplastic Syndromes MDS is an enigmatic and still poorly understood set of diseases that is pathogenetically related to MDR-AML [2]. Separation of MDS from AML is currently based empirically on the marrow blast percentage, rather than an understanding of biological differences in the two sets of disease [25, 26]. Intermediate and high-grade subsets of MDS (see below) are usually fatal with or without transformation to MDR-AML.

2 Core Binding Factor Mutations . . . . . . . 3 MLL Abnormalities . . . . 4 C/EBPa . . . . . . . . 5 GATA1 . . . . . . . . 6 FLT3 . . . . . . . . . 7 Other Tyrosine Kinase and RAS Mutations in AML . . . . 8 Nucleophosmin . . . . . 7 Microarray Analysis of Acute Leukemia . . . . . . . . . 8 Detection of Minimal Residual Disease (MRD) . . . . . . . 1. Morphologic (modified FAB) description of acute myeloid leukemia [1] M0 AML with no Romanowsky or cytochemical evidence of differentiation M1 Myeloblastic leukemia with little maturation M2 Myeloblastic leukemia with maturation M3 Acute promyelocytic leukemia (APL) M3h APL, hypergranular variant M3v APL, microgranular variant M4 Acute myelomonocytic leukemia (AMML) M4eo AMML with dysplastic marrow eosinophils M5 Acute monoblastic leukemia (AMoL) M5a AMoL, poorly differentiated M5b AMoL, differentiated M6 “Erythroleukemia” * M6a AML with erythroid dysplasia M6b Erythroleukemia M7 Acute megakaryoblastic leukemia (AMkL) * most M6 is M6a, not erythroleukemia but AML with erythroid dysplasia.

1 Bone Marrow Sampling Poor bone marrow sampling presents sufficient recurring problems in diagnosis that a brief review of bone marrow technique is in order. Before performing marrow sampling, neophytes should review on a skeleton the generally neglected anatomy of the posterior iliac crest. It is important to be aware of the extensive innervation of periosteum. With proper technique, appropriate reassurance of the patient with attention to his anxiety, and generous local anesthesia including liberal numbing of periosteum on the posterior iliac crest, the bone marrow procedure is usually well tolerated by adolescents and adults without general anesthesia.

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