Overview AML for amali

Bone marrow aspirate smear,Wright-Giemsa stain (1000 times)

Acute Myeloid Leukaemia (AML)

> 30% sel blast dalam sum-sum tulang

terdapat Auer's rods(pengumpulan atau fusi primary granules) dalam sitoplasma Myeloblast dan promyelocytes

80% dewasa

15-20% budak

Acute Myeloid Leukaemia (AML)

Klasifikasi FAB (France America Britain)

M0 Undifferentiated AML

M1 AML with Minimal Maturation

M2 AML with Maturation

M3 Acute Promyelocytic Leukaemia

M4 Acute Myelomonocytic Leukaemia

M5 Acute Monocytic Leukaemia

M6 Erythroleukaemia atau Sindrom Di Guglielmo

M7 Acute Megakaryocytic Leukaemia atau Acute Myelofibrosis

Simptom klinikal

anaemia-pucat,lemah,letih & dyspnoea

neutropenia-fever & infection

thrombocytopenia-bleeding,bruishing & petecchial

sakit tulang & tulang lembut-proliferasi sel marrow meningkat

spleenomegaly, hepatomegaly & lymphadenopathy

Penyiasatan Makmal

1 Profil hematologi

Hb:rendah

RBC:normochromic normocytic.Terdapat juga macrocyte,tear drop cells,elliptocyte,spherocytes & schistocytes.Coarse basophilic stippling & NRBC

Platelet: thrombocytopenia

WBC:variable.Terdapat banyak blast cells dalam smear darah.Auer rods ada  mungkin ada dalam sitoplasma blast (M2) & multiple Auers rods atau faggots (M3).Neutropenia & terjumpa sel-sel blast  seperti promyelocytes,Myelocytes,& metamyelocytes

2.Bone Marrow:Hypercellular.Sel blast > 30% dalam marrow

3.Cytochemistry

Cytochemistry stains

Peroxidase/Sudan Black B +ve

Naphthal AS-D Chloroacetate

(Specific Esterase ) +ve

Periodic Acid Schiff (PAS) -ve

Alpha-Naphthyl Acetate

(Non specific esterases) +ve(M4 & M5)

Serum/Urine Muramidase +ve(M4 & M5)

Acid Phosphatase -ve

4.Immunophenotyping (marker studies)

5.Chromosome studies (Cytogenetic0

6.Molecular analysis

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