Acute myelomonocytic leukemia

Synonyms

AML-M4
Acute myeloblastic leukemia type 4
AML M4

Overview

Acute myelomonocytic leukemia is a form of acute myeloid leukemia which involves a proliferation of CFU-GM myeloblasts and monoblasts. Progression from myelodysplastic syndrome has been reported.

It is classified under "M4" in the French-American-British classification (FAB).

It is classified under "AML, not otherwise classified" in the WHO classification.

Translocations have been observed.

Symptoms

  • Acute Disease
  • Blast Crisis
  • Bone Marrow Cells
  • Granulocyte Colony Stimulating Factor, Recombinant
  • Granulocyte Colony-Stimulating Factor
  • HIV Infections
  • Humans
  • Leukemia
  • Leukemia, Myeloid, Acute
  • Leukemia, Myelomonocytic, Acute
  • Neutropenia
  • Receptors, Granulocyte Colony-Stimulating Factor
  • Zidovudine

Treatment

Systemic chemotherapy includes alkylating agents — usually chlorambucil, cyclophosphamide, vincristine, or fludarabine (singly or in combination) — and steroids (prednisone) when autoimmune hemolytic anemia or thrombocytopenia occurs. An advance in the treatment of CLL has been the emergence of the humanized monoclonal antibodies rituximab and alemtuzumab. Alemtuzumab acts as an antibody against the surface of CLL cells and is used when fludarabine fails. Rituximab, a monoclonal antibody, acts similiarly to alemtuzumab; studies are ongoing. When chronic lymphocytic leukemia causes obstruction or organ impairment or enlargement, local radiation treatment can be used to reduce organ size. Allopurinol can be given to prevent hyperuricemia, a relatively uncommon finding. Prognosis is poor if anemia, thrombocytopenia, neutropenia, bulky lymphadenopathy, and severe lymphocytosis are present.

Resources

  • NIH