Lightning Learning: Acute Myeloid Leukaemia

““AML peak incidence is 85-89 years. Often curable, but some will die within 24-48 hours of admission.””

— advice is based on local guidelines & procedures

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STOP!

There are 50-60 new cases a year in Leicester, UK – often curable but some will die in the first 24-48 hours of admission. In 2015 there were 3126 cases in the UK alone.

Peak incidence is 85-89 years

Many will initially present through the ED, but not all are critically ill on presentation. Think of acute leukaemia in patients with:

• New onset fatigue

• Anaemia

• Unresolving infection & fever

• Unexplained bone pain

• Abnormal bruising & bleeding

LOOK

Patients may present with severe sepsis or DIC – manage as per the Sepsis 6 whilst awaiting haematology doctors.

Bloods: FBC, Blood film, Renal function, Electrolyte, Clotting including Fibrinogen, CRP.

Neutropenic? Isolate the patient

If anaemic then transfuse with caution – giving packed red cells to a patient with a high WCC can cause hyperviscous stroke → Discuss with Haematology.

In frail co-morbid patients, treatment may not be possible and good palliation is key.

LEARN

• BMJ: Acute Myelogenous Leukaemia
• LITFL: Haematological Emergencies
• Cancer Research UK: Acute myeloid leukaemia (AML) incidence statistics