Summary
Definition
History and exam
Key diagnostic factors
- palidez
- equimoses ou petéquias
Other diagnostic factors
- fadiga
- tontura
- palpitações
- dispneia
- febre e infecções
- linfadenopatia
- hepatoesplenomegalia
- sangramento das mucosas
- massa testicular
- massa cutânea (por exemplo, sarcoma mieloide)
- infiltração na pele
- aumento gengival
- dor óssea
- sintomas gastrointestinais (por exemplo, dor abdominal intensa)
- sintomas neurológicos (por exemplo, cefaleia, confusão)
Risk factors
- idade superior a 65 anos
- tratamento prévio com quimioterapia
- distúrbios hematológicos prévios
- doenças genéticas hereditárias
- anomalias cromossômicas constitucionais
- exposição à radiação ionizante
- exposição ao benzeno
- exposições ambientais
- sexo masculino
Diagnostic investigations
1st investigations to order
- Hemograma completo com diferencial
- esfregaço de sangue periférico
- painel da coagulação
- eletrólitos séricos
- ácido úrico sérico
- lactato desidrogenase (LDH) sérica
- função renal
- testes da função hepática
- avaliação da medula óssea
- teste genético
Investigations to consider
- teste genético para síndrome de predisposição à neoplasia hematológica hereditária
- tipagem do antígeno leucocitário humano (HLA)
- Imagem do SNC e punção lombar
- FDG-PET/CT
- radiografia torácica
- ecocardiograma
- angiografia sincronizada multinuclear
- tipagem do antígeno leucocitário humano (HLA)
Treatment algorithm
LMA recém-diagnosticada: apto para quimioterapia intensiva
LMA recém-diagnosticada: não apto para quimioterapia intensiva
leucemia promielocítica aguda (LPA) de não alto risco recém-diagnosticada
leucemia promielocítica aguda (LPA) de alto risco recém-diagnosticada
remissão completa: LMA
remissão completa: leucemia promielocítica aguda (LPA)
LMA refratária ou recidivada
leucemia promielocítica aguda (LPA) recidivada ou refratária
Contributors
Authors
Vijaya Raj Bhatt, MBBS, MS
Associate Professor
Section Leader, Malignant Hematology
University of Nebraska Medical Center Division of Hematology-Oncology
Nebraska
NE
Disclosures
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
Disclosures
PD declares that he has no competing interests.
Acknowledgements
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.
Disclosures
KR declares that she has no competing interests. PM is an author of a reference cited in this topic.
Peer reviewers
Naveen Premnath, MD
Assistant Professor of Medicine
Division of Hematology, Oncology, and Transplantation
University of Minnesota
Minnesota
MN
Disclosures
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
Раскрытие информации
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
Раскрытие информации
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
Раскрытие информации
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
Раскрытие информации
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.
Список литературы
Основные статьи
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.Полный текст Аннотация
National Cancer Comprehensive Network. NCCN guidelines in oncology: acute myeloid leukemia [internet publication].Полный текст
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.Полный текст Аннотация
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.Полный текст Аннотация
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.Полный текст Аннотация
Статьи, указанные как источники
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Leucemia linfoide aguda (LLA)
- Leucemia bifenotípica
- Neoplasias mieloides/linfoides com eosinofilia e genes de fusão de tirosina quinase (MLNE)
Больше DifferentialsDiretrizes
- NCCN guidelines in oncology: acute myeloid leukemia
- NCCN practice guidelines in oncology: hematopoietic cell transplantation
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