Info

🌱 來自: acute leukemia

diagnostic evaluation 

(Blood 2009;114:937)

* Peripheral smear: thrombocytopenia, blasts (seen in >95%; ⊕ Auer Rods in AML)

* Bone marrow: >20% blasts; mostly hypercellular; test for cytogenetics and flow cytometry for immunophenotype (AML/ALL)

* Cytogenetic anomalies: eg, in AML, t(15;17), t(8;21), inv(16) or t(16;16), complex; in ALL, Ph-chromosome [t(9;22)], hyper or hypodiploid, complex

• Molecular mutations in AML: esp FLT3 (ITD and TKD), TP53, NPM1; ALL_: BCR-ABL1_

• Evaluate for complications: TLS (↑ uric acid, ↑ LDH, ↑ K, ↑ PO4, ↓ Ca), DIC (PT, PTT, fibrinogen, D-dimer, haptoglobin, bilirubin), check for G6PD (prior to giving rasburicase)

• LP (w/ co-admin of intrathecal chemotherapy to avoid seeding CSF w/ circulating blasts) for all Pts w/ ALL (CNS is sanctuary site) and for Pts w/ AML w/ CNS sx

• TTE before use of anthracyclines

* HLA typing of Pt, siblings >parents/children for potential allogeneic HSCT candidates