Haem: Acute Myeloid Leukaemia: Free MSRA Podcast

🧬 FREE MSRA PODCAST – Acute Myeloid Leukaemia: Fast Facts & High-Yield RevisionIn this high-yield deep dive, we simplify the essentials of Acute Myeloid Leukaemia (AML) for the MSRA exam. We’ll cover the definitions, classifications, causes, red-flag symptoms, investigations, treatment pathways, and key complications. 🎯🧠 Key Learning Points📌 DefinitionAML = cancer of myeloid precursors in the bone marrow, leading to >20% blasts in marrow or blood. These abnormal cells multiply rapidly, suppressing normal cell production.📌 Classification Systems🔹 WHO Classification (modern, genetic-based)– Recurrent genetic abnormalities (e.g. t(15;17) in APL)– AML with myelodysplasia-related changes– Therapy-related AML– AML, NOS (not otherwise specified)– Myeloid sarcoma, AML in Down’s syndrome🔹 FAB Classification (M0–M7) – Mnemonics help:M0: Minimal diffM1: No maturationM2: Granulocytic maturationM3: APL (t(15;17), DIC risk, ATRA treatment)M4: MyelomonocyticM5: Monocytic (M5a = immature, M5b = mature)M6: Erythroid (M6a = erythroleukaemia)M7: Megakaryoblastic📌 Causes & Risk Factors• Often idiopathic, but core cause = genetic mutations• Risk factors: – Prior chemo/radiation – Benzene exposure (esp. M6) – Smoking – Genetic syndromes: Down’s, Fanconi, Bloom – Pre-existing blood disorders (MDS, polycythaemia, aplastic anaemia) – Transformation from other leukaemias (e.g. CML blast crisis)📌 Pathophysiology• Uncontrolled proliferation of immature myeloid blasts• Bone marrow fails → anaemia, thrombocytopenia, neutropenia• Blasts infiltrate other organs (spleen, liver, CNS, gums)📌 Clinical Features🎯 Mnemonic: ABC of AMLA – Anaemia: fatigue, SOB, pallorB – Bleeding: bruising, petechiae, nose/gum bleedsC – Cytopenia: infections, feverOther signs: bone pain, hepatosplenomegaly, gum hypertrophy, leukostasis (dyspnoea/confusion if high WCC)🧠 APL (M3): DIC at presentation, t(15;17), treated with ATRA ± arsenic📌 Investigations• FBC: ↓ Hb, ↓ platelets, variable WCC, blasts on film• Coagulation screen (especially in M3)• Bone marrow biopsy = diagnostic (≥20% blasts)• Flow cytometry (confirm lineage)• Cytogenetics & molecular markers (e.g. FLT3, NPM1)• CXR, ECG, ECHO before chemo• Infection screen, LFTs, U&Es, LDH📌 Management Overview🎯 Mnemonic: I.C.T.S.I – Induction chemo (e.g. cytarabine + daunorubicin)C – Consolidation (chemo or stem cell transplant)T – Targeted therapy (e.g. FLT3 inhibitors, ATRA for APL)S – Supportive care: transfusions, antibiotics, tumour lysis prophylaxis• Maintenance: NICE recommends oral azacitidine in some cases• Stem cell transplant: Allo-SCT for high-risk or persistent disease• APL: ATRA + arsenic trioxide (excellent prognosis if treated early)📌 Prognosis & Survival• Better if: young, good performance status, favourable cytogenetics• Poorer with: age >60, FLT3-ITD, therapy-related AML, CNS involvement, complex cytogenetics• 5-year survival: – Adults: ~17% – Children: 65–75%📌 Complications• Infection, bleeding, anaemia• DIC (esp. in APL)• Leukostasis• Tumour lysis syndrome• Long-term risks: secondary cancers, organ toxicity, psychological stress📎 More MSRA Resources for AML📝 Revision Notes:https://www.passthemsra.com/topic/acute-myeloid-leukaemia-revision-notes/🧠 Flashcards:https://www.passthemsra.com/topic/acute-myeloid-leukaemia-flashcards/💬 Accordion Q&A Notes:https://www.passthemsra.com/topic/acute-myeloid-leukaemia-accordion-qa-notes/🚀 Rapid Quiz:https://www.passthemsra.com/topic/acute-myeloid-leukaemia-rapid-quiz/🎓 Haematology Course:https://www.passthemsra.com/courses/haematology-for-the-msra/#MSRA #AcuteMyeloidLeukaemia #AMLMSRA #MSRAHaematology #MSRAFlashcards #MSRAQuiz #PassTheMSRA #FreeMSRA #MSRARevisionNotes #M3APL #HaematologyMSRA