Acute Monocytic Leukimia

Acute monocytic leukemia ( AMoL,or AML-M5 ) is considered a type of acute myeloid leukemia.

Diagnosis

World Health Organization ( WHO ) criteria for AML-5, a patient must have greater than 20% blasts in the marrow, and of these, greaterthan 80% must be of the monocytic line age. A further subclassification (M5aversus M5b) is made depending on whether the monocytic cells are predominantlymonoblasts (80%) (acute monoblastic leukemia) or a mixture of monoblastsand promonocytes(<80%>

Immunophenotypically, M5-AML variably express myeloid (CD13,CD33) and monocytic (CD11b, CD11c) markers. Cells may aberrantly express B-cellmarker CD20 and the NK marker CD56. Monoblasts may be positive for CD34.

Causes

M5 is associated with characteristic chromosomal abnormalities, often involving 11q23 or t(9;11)affecting the MLL locus, howeverthe MLL translocation is also found in other AML subtypes. MLL is believed tobe prognostically unfavorable in AML-M5 compared to other genetic alterations involving MLL such as t(9;11) The t(8;16) translocation in MLL is associatedwith hemophagocytosis.

AML-M5 is thought tobe associated with exposure to epidophyllotoxic.

Treatment

AML-M5 is treated with intensive chemotherapy (such as anthracyclines) or with bone marrow transplantation.

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