Acute Leukemia

1. LYMPHOBLASTIC
2. MYELOBLASTIC

DIAGNOSIS

BLOOD COMPLETE PICTURE

BONE MARROW EXAMINATION

a – MORPHOLOGY

b –  CYTOCHEMISTRY

c –   IMMUNOPHENOTYPING

d –  CYTOGENETICS

CLASSIFICATION(WHO)

LYMPHOBLASTIC LEUKAEMIA

• PRECURSER B CELL
• PRECURSER T CELL

ACUTE MYELOBLASTIC LEUKAEMIA

• AML WITH RECURRENT GENETIC ABNORMALITIES
• AML WITH MULTI LINEAGE DYSPLASIA
• THERAPY RELATED AML
• AML NOT OTHERWISE CATEGORISED
• ACUTE LEUKAEMIA OF AMBIGOUS LINEAGE

MANAGEMENT

CYTOGENETICS

STANDARD RISK- t(8:21) t(15:17) inv(16)

INTERMEDIATE RISK

POOR RISK(5-7-3q-)

SUPPORTIVE MANAGEMENT

TREATMENT OF SEPSIS

NUTRITION

TRANSFUSION OF BLOOD COMPONENT

NURSING CARE

SPECIFIC MANAGEMENT

LUMPHOBLASTIC

a- REMISSION INDUCTION

• vincristine, daunorubicin, L-asparaginase
• prednisolone, intrathecal methotrexate

b- INTENSIFICATION

• vincristine, daunorubicin, cytarabine,
• etoposide,  thioguanine, prednisolone,
• intrathecal methotrexate

c- CNS TREATMENT

cranial radiation, intrathecal methiteraxate,

d-    MAINTENANCE

6- Mercaptopurine, methotrexate, vincristine, prednisolone

GOOD RISK:

STANDARD TREATMENT

POOR RISK

ALLOGENIC BONE MARROW TRANSPLANT

ACUTE MYELOID LEUKAEMIA

REMISSION INDUCTION

D3A7

ADE7

ADE5

POST REMISSION INTENSIFICATION

HIGH DOSE CYTARABINE

D3A7, ADE7, ADE5

ALLOGENIC BONE MARROW TRANSPLANT

ACUTE PROMYELOCYTIC LEUKAEMIA

REMISSION INDUCTION

• ATRA+IDARUBICIN
• ATRA+DAUNORUBICIN

INTENSIFICATION

• IDARUBICIN
• MITOZANTRON
• IDARUBICIN

MAINTENANCE

• 6- MERCEPTOPURIN
• METHOTREXATE
• ATRA

Want a clearer concept, also see

Chronic Leukemia
Chemotherapy and Radiation