What are the causes and diagnosis of Acute myeloblastic leukemia type 4?

March 07 22:41 2019 Print This Article

What are the causes of acute myeloblastic leukemia type 4?

There are number of factors which can cause this disorder. It includes the blood disorders, chemical exposures and genetics. It also includes the ionizing radiations also. There are pre leukemic blood disorders like myelo dysplastic syndrome or myelo proliferative disease which involves the AML. The exact risk factor depends on the type of MDS or MPS. The exposure to anti cancer chemo therapy along with the alkylating agents increases the risk of this disorder. The risk is highest about 3 to 5 years after chemo therapy. There are other chemo therapy agents like epi podo phyllo toxins and anthrax cyclines.

They are linked with the treatment related leukemia. They are mainly associated with the chromosomal abnormalities in the cell. The occupational chemical exposure to the benzene and other aromatic organic solvents can lead to this disorder. The benzene and its derivatives are referred as a carcinogenic. There is a link between the carcinogens and the risk associated with the occurrence of this disorder. There are radiations of ions which can lead to this disorder. The increased rate of AML is due to the atomic bombings of Hiroshima and Nagasaki. The radiologists were also exposed to the high level of radiations prior to the modern safety practices. There is a hereditary risk associated with the AML. There are many cases of the AML in a family which has a higher risk of developing by a chance alone.

The increase in the chance of developing AML is many times more than in the first degree relatives as compared to the non relatives. There are many congenital conditions which have increased the chance of this disorder and the most common condition is the Down syndrome which increases the thresh hold around 20 times.

What is the diagnosis of acute myeloblastic leukemia type 4?

It is mainly done with the help of complete blood cell count. In this there are more number of white blood cells which is a common finding and leads to the leukemic blast. There is a decrease in the platelets and red blood cell count. One can also see a decrease in the white blood cell count. It is referred as a leucopenia. The diagnosis can also be done by the blood smear count which can show the circulating leukemic blasts. It is a definite diagnosis and requires a bone marrow aspiration along with the biopsy.

The blood is examined with the help of light microscopy. The flow cytometry is also helpful and it differentiates between the AML and leukemia. It classifies the sub types of disease. The sample of marrow is helpful to know about the chromosomal translocations. It is a done with the help of cyto genetics or fluorescent in situ hybridization. There are genetic studies which help us to look for specific mutation in different genes. It influences the outcome of disease. The cyto chemical stains on blood and bone marrow are helped to distinguish the AML from ALL. It also sub classifies the AML.

The combination of esterase and myelo peroxides is very helpful in the identification of AML and differentiating from the ALL. There are nonspecific esterase stains which are used to identify the monocytic component in AML and to differentiate the monoblastic leukemia from ALL. The diagnosis and classification of this disorder is controversial and can be challenged. It must be done by the hemato pathologist or hematologist.

The presence of certain features like auer rods or a specific flow cytometry which can differentiate the AML from other leukemia. If there are no such features the diagnosis may be very difficult. As per the WHO criteria the diagnosis of AML is established by the involvement of more than 20 percent of the cells of blood and marrow. It occurs by leukemic myeloblasts. The AML can be differentiated from the pre leukemic conditions by myelo dysplastic or myelo proliferative syndromes. They are treated differently.

The highest curability is seen in the APL which is referred as the acute pro myelocytic leukemia. It requires a unique treatment and it is important to exclude the diagnosis of sub type of leukemia. A fluorescent in situ hybridization is performed on blood and is used for this purpose. It identifies the chromosomal translocation which characterizes the APL.

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