Acute monocytic leukemia (AMoL, or AML-M5) is considered a type of acute myeloid leukemia. In order to fulfill World
Health Organization (WHO) criteria for AML-5, a patient must have greater than 20% blasts in the bone marrow, and of
these, greater than 80% must be of the monocytic lineage. A further subclassification (M5a versus M5b) is made depending on
whether the monocytic cells are predominantly monoblasts (>80%) (acute monoblastic leukemia) or a mixture of monoblasts
and promonocytes (<80% blasts). Monoblasts can be distinguished by having a roughly circular nucleus, delicate lacy chromatin,
and abundant, often basophilic cytoplasm. These cells may also have pseudopods. By contrast, promonocytes have a more convoluted
nucleus, and their cytoplasm may contain metachromatic granules. Monoblasts are typically MPO negative and promonocytes are MPO
variable. Both monoblasts and promonocytes stain positive for non-specific esterase (NSE), however NSE may often be negative.
Immunophenotypically, M5-AML variably express myeloid (CD13, CD33) and monocytic (CD11b, CD11c)
markers. Cells may aberrantly express B cels marker CD20 and the NK marker CD56. Monoblasts may be positive for CD34.
M5 is associated with characteristic chromosomal abnormalities, often involving 11q23 or t(9;11)affecting the MLL locus,
however the MLL translocation is also found in other AML subtypes. MLL is believed to be prognostically unfavorable in AML-M5
compared to other genetic alterations involving MLL such as t(9;11) The t(8;16) translocation in MLL is associated with
hemophagocytosis.
AML-M5 is thought to be associated with exposure to epidophyllotoxins.
AML-M5 is treated with intensive chemotherapy (such as anthracyclines) or with bone marrow transplantation.
External links
|
Pathology: hematology
(primarily
C81-C96/200-208,
D45-D47, D50-D77/280-289) |
| WBCs |
hematological
malignancy (Lymphoma, leukemia)
-cytosis (Agranulocytosis, Leukocytosis,
Lymphocytosis, Monocytosis) • -penia
(Lymphopenia, Neutropenia) |
RBCs/anemia/
hemoglobinopathy |
nutritional anemia: Iron deficiency anemia, Plummer-Vinson syndrome,
Megaloblastic anemia (Pernicious
anemia)
hereditary hemolytic anemia: G6PD Deficiency, Thalassemia,
Sickle-cell disease/trait,
Hereditary spherocytosis, Hereditary elliptocytosis, Hereditary
stomatocytosis
acquired hemolytic anemia: Warm autoimmune hemolytic anemia,
HUS, MAHA,
PNH
aplastic anemia: Acquired
PRCA, Diamond-Blackfan anemia, Fanconi
anemia • Sideroblastic anemia • Hemochromatosis |
| Coagulation/platelets |
coagulopathy:
DIC • Hemophilia
(A, B, C,
XIII) • Von Willebrand
disease
Purpura: Henoch-Schönlein,
ITP, TTP
primary hypercoagulable state: Protein C deficiency - Protein S deficiency - Antithrombin III
deficiency
other hemorrhagic conditions: Bernard-Soulier syndrome -
Glanzmann's thrombasthenia - Grey
platelet syndrome |
| Histiocytosis |
WHO-I Langerhans cell histiocytosis - non-Langerhans-cell histiocytosis/WHO-II
(Juvenile xanthogranuloma, Hemophagocytic lymphohistiocytosis) - malignant histiocytic disorders/WHO-III
(Acute monocytic leukemia, Malignant
histiocytosis, Erdheim-Chester disease) |
| Other |
Asplenia/hyposplenism -
Methemoglobinemia |
|
Hematological malignancy histology
(ICD-O 9590-9989) |
| Lymphomas (9590-9759) |
Hodgkin's lymphoma
vs. Non-Hodgkin lymphoma - Diffuse
lymphoma vs. Follicular lymphoma
B-cell lymphoma (Small cell,
Primary effusion, Diffuse
large, ,Burkitt's, Splenic
marginal zone, MALT)
T-cell lymphoma (Cutaneous ,
Mycosis fungoides/Sézary's disease,
Angioimmunoblastic, Anaplastic large cell, Hepatosplenic)
plasma cell (Plasmacytoma, Multiple myeloma)
mast cell tumor (Mast-cell sarcoma,
Malignant mastocytosis, Malignant
histiocytosis, Langerhans cell histiocytosis) |
| Immunoproliferative disorders (9760-9799) |
Waldenström macroglobulinemia - Lymphomatoid
granulomatosis |
| Lymphoid leukemias (9800-9839) |
ALL -
CLL - T-cell leukemia
(Adult, Large granular
lymphocyte, Prolymphocytic, Acute lymphoblastic) - B-cell
leukemia (Prolymphocytic) |
| Myeloid leukemias (9840-9939, 9963) |
AML (M2, APL/M3, AMoL/M5, Erythroleukemia/M6) - CML (CMoL, CNL, Philadelphia chromosome) - Granulocytic
sarcoma |
| Other leukemias (9940-9949) |
Hairy cell
leukemia - Aggressive NK-cell leukemia |
| Myeloproliferative disease (9950-9961) |
Polycythemia vera - Essential thrombocytosis -
Myelofibrosis |
| Other (9964-9989) |
Hypereosinophilic
syndrome - Post-transplant lymphoproliferative
disorder - Myelodysplastic syndrome |
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