Acute nonlymphocytic leukemia

Acute Nonlymphocytic Leukemia

Acute Nonlymphocytic Leukemia (ANLL), also known as Acute Myeloid Leukemia (AML), is a type of cancer that affects the blood and bone marrow. It is characterized by the rapid growth of abnormal white blood cells that accumulate in the bone marrow and interfere with the production of normal blood cells. ANLL is a serious condition that requires prompt medical attention.

Pathophysiology

ANLL is caused by genetic mutations in the myeloid line of blood cells. These mutations lead to the uncontrolled proliferation of immature white blood cells, known as myeloblasts. These myeloblasts fail to mature into healthy white blood cells and accumulate in the bone marrow, leading to bone marrow failure and the subsequent reduction in the production of normal blood cells.

Symptoms

The symptoms of ANLL are often related to the lack of normal blood cells and may include:

• Fatigue and weakness due to anemia
• Frequent infections due to neutropenia
• Easy bruising or bleeding due to thrombocytopenia
• Fever
• Bone pain
• Weight loss

Diagnosis

The diagnosis of ANLL is typically made through a combination of:

• Complete blood count (CBC) showing anemia, thrombocytopenia, and leukocytosis with circulating blasts
• Bone marrow biopsy revealing a high percentage of myeloblasts
• Cytogenetic analysis to identify specific chromosomal abnormalities
• Molecular testing for genetic mutations such as FLT3, NPM1, and CEBPA

Treatment

The treatment of ANLL involves several approaches:

• Induction chemotherapy: The initial phase of treatment aimed at achieving remission. Common regimens include cytarabine and an anthracycline such as daunorubicin.
• Consolidation therapy: Post-remission therapy to eliminate residual disease, often involving high-dose chemotherapy or stem cell transplantation.
• Targeted therapy: For patients with specific genetic mutations, targeted therapies such as FLT3 inhibitors may be used.
• Supportive care: Management of symptoms and complications, including blood transfusions, antibiotics, and growth factors.

Prognosis

The prognosis of ANLL varies depending on several factors, including the patient's age, overall health, and specific genetic mutations present in the leukemia cells. Younger patients and those with favorable genetic profiles tend to have better outcomes.

Epidemiology

ANLL is more common in adults than in children, with the incidence increasing with age. It is the most common acute leukemia affecting adults.

Also see

• Leukemia
• Bone marrow biopsy
• Chemotherapy
• Stem cell transplantation