Page 1 of 1: subtype of acute myelogenous leukemia in this woman?

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A 35-year-old woman presents to a physician with complaints of several months of fatigue and malaise. Hematologic workup performed during her evaluation demonstrates acute myelogenous leukemia. She is placed on antileukemic therapy, but shortly after her first dose of
antineoplastic agents, she develops hemorrhage and clotting phenomena and a diagnosis of disseminated intravascular coagulation (DIC) is made. Which of the following is the most likely subtype of acute myelogenous leukemia in this woman?

Options:bbh

A. M1

B. M3

C. M5

D. M6

E. M7

mdali007 · Credits: 5763 My Scrapbook

The correct answer is B.

Disseminated intravascular coagulation can develop during treatment of acute myelogenous leukemias as a consequence of release of granules (in the form of Auer rods) from cells in the promyelocytic line. Anti-neoplastic agents may trigger this release of granules. This phenomenon is most striking in type M3 acute myelogenous leukemia, also known as promyelocytic leukemia. This form has the largest number of Auer rods in the cytoplasm of the leukemic cells. DIC is also occasionally seen (usually with less severe cases) in types M4 and M5. Patients with type M3 acute myelogenous leukemia require very careful management during the administration of chemotherapy, but have a very good long term prognosis if the DIC and hemorrhage are adequately controlled and treated.

M1 (choice A) is acute myelogenous leukemia without maturation, and is not usually associated with DIC.

M5 (choice C) is acute monoblastic leukemia and has some tendency to cause DIC, but less so than M3.

M6 (choice D) is acute erythroleukemia, and is not usually associated with DIC.

M7 (choice E) is acute megakaryoblastic leukemia, and is not usually associated with DIC.

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