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Leucemia mieloide aguda

Última revisão: 20 Aug 2025
Última atualização: 20 Jun 2025

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • palidez
  • equimosis o petequias
Detalhes completos

Outros fatores diagnósticos

  • fatiga
  • mareos
  • palpitaciones
  • disnea
  • fiebre e infecciones
  • linfadenopatía
  • hepatoesplenomegalia
  • sangrado mucoso
  • masa testicular
  • masa cutánea (p. ej., sarcoma mieloide)
  • infiltración cutánea
  • agrandamiento gingival
  • dolor óseo
  • síntomas gastrointestinales (por ejemplo, dolor abdominal severo)
  • síntomas neurológicos (por ejemplo, dolor de cabeza, confusión)
Detalhes completos

Fatores de risco

  • mayores de 65 años
  • tratamiento previo con quimioterapia
  • trastornos hematológicos previos
  • Trastornos genéticos hereditarios
  • anomalías cromosómicas constitucionales
  • exposición a la radiación ionizante
  • exposición al benceno
  • exposiciones ambientales
  • sexo masculino
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • hemograma completo (HC) con diferencial
  • frotis de sangre periférica
  • perfil de coagulación
  • electrolitos séricos
  • ácido úrico sérico
  • lactato deshidrogenasa (LDH) sérica
  • función renal
  • pruebas de función hepática
  • evaluación de la médula ósea
  • pruebas genéticas
Detalhes completos

Investigações a serem consideradas

  • pruebas genéticas para el síndrome de predisposición hereditaria a neoplasias malignas hematológicas
  • tipificación del antígeno leucocitario humano (HLA)
  • Estudios por imágenes del SNC y punción lumbar
  • exploración TEP-FDG/TC
  • radiografía de tórax
  • ecocardiograma
  • ventriculografía con radionúclidos
  • tipificación del antígeno leucocitario humano (HLA)
Detalhes completos

Algoritmo de tratamento

AGUDA

LMA recién diagnosticada: apta para quimioterapia intensiva

LMA recién diagnosticada: no apta para quimioterapia intensiva

leucemia promielocítica aguda (LPMA) de reciente diagnóstico y sin alto riesgo

leucemia promielocítica aguda (LPMA) de alto riesgo recién diagnosticada

CONTÍNUA

remisión completa: LMA

remisión completa: leucemia promielocítica aguda de alto riesgo (LPMA)

LMA en recidiva o refractaria

leucemia promielocítica aguda (LPMA) en recidiva o refractaria

Colaboradores

Autores

Vijaya Raj Bhatt, MBBS, MS

​Associate Professor

Section Leader, Malignant Hematology

University of Nebraska Medical Center Division of Hematology-Oncology

Nebraska

NE

Declarações

VRB has participated in a Safety Monitoring Committee for Protagonist Therapeutics. He serves as an Associate Editor for the Elsevier Journal, Current Problems in Cancer. He has received consulting fees from Imugene, Sanofi, and Taiho; research funding (institutional) from Abbvie, Pfizer, Incyte, Jazz, NMDP, MEI Pharma, Sanofi, and Actinium Pharmaceuticals; and drug support (institutional) from Chimerix for a trial.

Prajwal Dhakal, MBBS

Clinical Assistant Professor of Internal Medicine-Hematology, Oncology, and Blood and Marrow Transplantation

University of Iowa

Iowa City

IA

Declarações

PD declares that he has no competing interests.

Agradecimentos

Dr Vijaya Raj Bhatt and Dr Prajwal Dhakal would like to gratefully acknowledge Dr Kavita Raj and Dr Priyanka Mehta, previous contributors to this topic.

Declarações

KR declares that she has no competing interests. PM is an author of a reference cited in this topic.

Revisores

Naveen Premnath, MD

Assistant Professor of Medicine

Division of Hematology, Oncology, and Transplantation

University of Minnesota

Minnesota

MN

Declarações

NP declares that he has no competing interests.

Rebecca Connor, MD

Chief Fellow

Section of Hematology and Oncology

Department of Internal Medicine

Wake Forest University Baptist Medical Center

Winston-Salem

NC

Declarações

RC declares that she has no competing interests.

Roger M. Lyons, MD, FACP

Clinical Professor of Medicine

University of Texas Health Science Center

San Antonio

Cancer Care Network of South Texas

San Antonio

TX

Declarações

RML declares that he has no competing interests.

Shankaranarayana Paneesha, MD, MRCP, FRCPath

Consultant Haematologist

Department of Haematology and Stem Cell Transplantation

Heartlands Hospital

Birmingham

UK

Declarações

SP declares that he has no competing interests.

David Marks, MD, MRCP, MRCPath

Professor of Haematology & Stem Cell Transplantation

Department of Molecular and Cellular Medicine

University of Bristol

UK

Declarações

DM declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

Döhner H, Wei AH, Appelbaum FR, et al. Diagnosis and management of AML in adults: 2022 recommendations from an international expert panel on behalf of the ELN. Blood. 2022 Sep 22;140(12):1345-77.Texto completo  Resumo

National Cancer Comprehensive Network. NCCN guidelines in oncology: acute myeloid leukemia [internet publication].Texto completo

Heuser M, Ofran Y, Boissel N, et al. Acute myeloid leukaemia in adult patients: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2020 Jun;31(6):697-712.Texto completo  Resumo

Sekeres MA, Guyatt G, Abel G, et al. American Society of Hematology 2020 guidelines for treating newly diagnosed acute myeloid leukemia in older adults. Blood Adv. 2020 Aug 11;4(15):3528-49.Texto completo  Resumo

Sanz MA, Fenaux P, Tallman MS, et al. Management of acute promyelocytic leukemia: updated recommendations from an expert panel of the European LeukemiaNet. Blood. 2019 Apr 11;133(15):1630-43.Texto completo  Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Leucemia mieloide aguda images
  • Diagnósticos diferenciais

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    • Leucemia bifenotípica
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  • Diretrizes

    • NCCN guidelines in oncology: acute myeloid leukemia
    • NCCN practice guidelines in oncology: hematopoietic cell transplantation
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