Acute Myeloid Leukemia (AML) MCQs

Ans. is 'c' i.e., Myelophthisis type Myelophthisic anemia Space - occupying lesions that destroy significant amount of bone marrow or disturb the marrow architecture, depress its productive capacity. This form of anemia is referred to as myelophthisic anemia. Characteristically, immature erythroid and myeloid progenitors appears in the peripheral blood —> Leukoerythroblastosis. Causes are Metastatic cancer (M.C. cause) Granulomatous disease infiltrating bone marrow. Myeloproliferative disorders (such as myeloid leukemia) Myelofibrosis

In chloroma, there is extramedullary proliferation of blasts so its necessary to do a bone marrow evaluation to rule out concomitant leukemia. since bone marrow is not in option, peripheral smear is the next best answer. Since if the blasts are present in peripheral smear, it is suggestive of leukemia Reference: Robbins & Cotran Pathologic Basis of Diseases 10 th edition, chapter 13, pg 592

All trans retinoic acid is used in the treatment of Acute promyelocytic leukemia Acute promyelocytic leukemia (M3) with t(15;17) (q22;q12); PML/RAR-a Therapy with the retinoic acid analogue all trans retinoic acid can result in maturation of these leukemic cells and clinical remission Reference: Robbins & Cotran Pathologic Basis of Diseases 10 th edition, chapter 13, pg 588-590

Myeloid (granulocytic) sarcoma, or myeloblastoma are extramedullary blast proliferation.These tumors are called chloromas because some appear green or turn green in dilute acid secondary to expression of MPO. The tumors are usually localized; they often involve bone, periosteum, soft tissues, lymph nodes, or skin. Common sites are the orbit and the paranasal sinuses. The diagnosis can be made, if Auer rods are detected on blasts in peripheral smear or if myeloid origin is confirmed by cytochemical or immunohistochemical methods. The diagnosis should be suspected, if eosinophilic myelocytes are present in hematoxylin and eosin–stained biopsy sections. Imprint preparations can be helpful. Reference: Robbins & Cotran Pathologic Basis of Diseases 10 th edition, chapter 13, pg 601