clinical features of AML
Last reviewed 01/2018
Presentation of AML is usually with signs and symptoms caused by leukemic infiltration of the bone marrow and extramedullary sites (1).
- signs and symptoms of pancytopenia
- anaemia - fatigue, exertional dyspnoea, palpitations, angina or claudication
- thrombocytopenia - epistaxis, gingival haemorrhage, menorrhagia, cutaneous petechiae or occasionally significant gastrointestinal ,urinary or intracranial haemorrhage
- neutropaenia
- infections which are usually bacterial or fungal and common sites for sepsis
include the teeth and oropharynx, sinuses, lung, skin, perineum and bowel
- fever - presenting feature in around 15-20% of patients
- disseminated intravascular coagulation - although seen at presentation of
all AML subtypes, it is much more common in childhood acute promyelocytic
leukaemia (APL)
- infiltration of extramedullary sites can present as
- lymphadenopathy
- hepatosplenomegaly
- in CNS - involvement at diagnosis is seen in 15% of patients and usually manifests as leptomeningeal disease with headache and isolated cranial nerve palsies (especially V and VII), and intracranial masses
- in skin (leukaemia cutis) - occurs in about 10% of cases
- gingival infiltration
- testicular involvement - rarely
- features of hyperviscosity such as dyspnoea, hypoxia, respiratory failure, headache seizures, confusion, coma visual disturbances or priapism due to leucostasis is seen in patients who present with a blast count >50×109/l
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