5 Questions on the Diagnosis of Acute Myeloid Leukemia

November 1, 2016

Acute myeloid leukemia (AML) is the most common form of acute leukemia among adults, and annually accounts for the majority of deaths from acute leukemia in the United States. Test your knowledge about the diagnosis of AML in our latest quiz.

 

Question 1

Answer

B. One third

Median age of diagnosis is 67 years, with 54% of patients diagnosed at age 65 years or older (22% of the cases are diagnosed at age 75–84 and 10% at age > 84).[1-2]

 

Question 2

Answer

A. Lymphoma and breast cancer

Leukemogenic cytotoxic agents are commonly used to treat these tumors.[3]

 

Question 3

Answer

A. True

Patients with therapy-related APL have outcomes similar to those with de novo APL. Patients with favorable-risk cytogenetics-ie, t(15;17) and the core-binding factor cytogenetic abnormalities t(8;21), inv(16), or t(16;16)-seemingly have a more favorable clinical outcome compared to other types of therapy-related AML.[4]

 

Question 4

Answer

C. NPM1

Mutations in the NPM1 gene occur in 28% to 35% of cases of AML. An isolated NPM1 mutation confers a higher complete response rate than patients who are NK-AML and wild-type NPM1. However, the NPM1 mutation appears to confer an overall favorable prognosis only in the absence of FLT3-ITD in patients treated only with chemotherapy.[5]

 

Question 5

Answer

A. AML with BCR-ABL1 and AML with mutated RUNX1

A rare de novo AML, AML with BCR-ABL1 may benefit from treatment with tyrosine kinase inhibitors. AML patients with RUNX1 may have a poorer prognosis.[6]

References:

1. National Comprehensive Cancer Network. Acute myeloid leukemia (Version 2.2016). https://www.nccn.org/professionals/physician_gls/pdf/aml.pdf. Accessed October 22, 2016.

2. SEER Cancer Statistics Factsheets: Acute myeloid leukemia. National Cancer Institute. Bethesda, MD. Available at: http://seer.cancer.gov/statfacts/html/amyl.html. Accessed October 30, 2016.

3. Becker PS. The origin of therapy-related AML Lies Deep Within. The Hematologist. 2015;12:13.

4. Beaumont M, Sanz M, Carli PM, et al. Therapy-related acute promyelocytic leukemia. J Clin Oncol. 2003;21:2123–2137.

5. Thiede C, Koch S, Creutzig E, et al. Prevalence and prognostic impact of NPM1 mutations in 1485 adult patients with acute myeloid leukemia (AML). Blood. 2006;107:4011–4020.

6. Arber DA, Orazi A, Hasserjian R, et al. The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood. 2016;127:2391–2405.