BARBA, ANNIKA Y.

BSN4
AML PATHOPHYSIOLOGY

ACUTE MYELOID LEUKEMIA PATHOPHYSIOLOGY

DIAGRAM DISCUSSION

Acute myeloid leukemia (AML) is a neoplastic disease characterized by - infiltration of the blood, - bone marrow, and - proliferative, clonal undifferentiated cells of the
hematopoietic system. A person can acquire this disease if he’s expose to radiation, certain chemicals like benzene or could be hereditary. People who are getting older (50-60 yrs
old even older) are also at risk to catch this disease as well as people who have blood disorders are also vulnerable to this.

Usually the normal function of hemopoietic stem cell, it differentiates Myeloid stem cell or Lymphoid stem cell, these two are also called precursor cell blast and it can go
through one of them. When it goes to the Myeloid stem cell it will go through and make specialize cells like RBC, Monocytes, Granulocytes, Megakaryocytes and others.
Alternatively, it can choose to go through lymphoid stem cell route which has B and T cells of the immune system. In the diagram shown, Acute Myeloid Leukemia starts when the
Hemopoietic stem cell loses its ability to differentiate or mature into the specialize cells under the two Precursor cell blast leading to abnormal hematopoiesis. When it gets to
Myeloid stem cell and couldn’t differentiate any further so they start to build up resulting to Myeloblast abnormality that will also result to frozen cell maturation.

I will discuss the left side of the diagram

Presence of myeloblast abnormality will obviously emerge into Myeloblast that makes the cells mutate into immature cells, decreasing proliferation control, making
disruption of normal cells/genes. Since it cannot differentiate what to make, it will produce immature cells, causing build up and increase in number of immature or abnormal
cells production in the bone marrow. Since, it doesn’t make the right specialize cells like RBC, leukocytes, neutrophils platelets and etc, there would be an excess abnormal cells
into the bone barrow. Knowing that there’s decrease control production of it, the abnormal cells will make an excess going into the blood stream, making your white blood cell to
increase that will result to enlargement of liver and spleen. Spleen performs "quality control"; your red blood cells must pass through a maze of narrow passages. Healthy blood
cells simply pass through the spleen and continue to circulate throughout your bloodstream but since they are not healthy cells they accumulate and cannot pass through the narrow
BARBA, ANNIKA Y.
BSN4
AML PATHOPHYSIOLOGY

passages. While liver on the other hand, makes certain proteins for blood plasma. Makes cholesterol and special proteins to help carry fats through the body, unfortunately, with
acute myeloid leukemia, it cannot do it’s normal function, which lead to infiltration that cause it to become enlarge. Manifestations are: ABDOMINAL DISTENTION ,
HEPATOMEGALY and SPLEENOMEGALY. Not only it will affect the liver and the spleen, it will also affect the kidneys, resulting to renal insufficiency; symptoms: pitting
bipedal edema and lead to uremia. In addition, lungs and bones get affected as well. Increase in WBC in bones will lead to Bone marrow failure.

Now I will discuss the Center part of the Diagram then the right side and its relation

As mentioned above that when it gets to Myeloid stem cell and couldn’t differentiate any further so they start to build up resulting to Myeloblast abnormality that will also
result to frozen cell maturation leading to have an arrest of cellular differentiation or in simple words, they cannot differentiate or mature into right specialize cells.

Myeloblasts make copies of themselves quickly and slows the production of red blood cells and platelets, causing tiredness from anemia and a risk of bleeding tendencies
from a low platelet count resulting into having petechiae and bruising that will need blood transfusion. Since there’s slow or low production of red blood cells it will decrease
concentration of oxygen because one protein present in RBC is hemoglobin which carries oxygen from the lungs and distribute it to all body parts and it will also result to low
hematocrit production that will give the patient signs and symptoms such as: Body malaise, nasal flaring, palmar pallor, chest indrawing, weakness thread pulse, kussmaul’s
respiration, increase heart rate and use of accessory muscles.

There’s also an increased risk of infection, since infection-fighting white blood cells are not maturing and cannot fight off infection making the body vulnerable to severe
bacterial and viral infections. Moreover, the body will have a triggering changes that can damage multiple organ systems (Sepsis) and if not treated will lead to death.

Lastly, the treatment for Acute Myeloid Leukemia is usually includes blood transfusion and chemotherapy.
BARBA, ANNIKA Y.
BSN4
AML PATHOPHYSIOLOGY

Precipitating factors:
Predisposing factors: • Smoking
• Age • Exposure to radiation
• Genes/Hereditary • Undergoing chemotherapy
Acute Myeloid Leukemia
• Blood disorders
.

Abnormal hematopoiesis
Blood transfusion

petechiae

Increased Bleeding Tendencies Decrease platelet

Myeloblast Myeloblast abnormality count
bruises

Decrease RBC count, platelet

Cell Mutation Frozen cell maturation count, and immature
leukocytes

Decreased Proliferation Arrest of Cellular Differentiation

High numbers of immature or
Control
abnormal leukocytes are
unable to fight and destroy
microorganisms
BARBA, ANNIKA Y.
Disrupted Genes
BSN4
AML PATHOPHYSIOLOGY
Decreased Oxygen
Concentration/ Distribution Severe bacterial and viral
in the blood infections
Immature Clone of Cells
Decrease hematocrit

Rapid Proliferation of Abnormal Cells Body malaise

sepsis
Nasal flaring

Palmar pallor Chest indrawing

Abnormal, immature
leukocytes circulate the
bloodstream
Weak, thread pulses
Pale, dry mucous membranes
Increased heart rate
Kussmaul’s respirations
Multi-organ dysfunction
Use of accessory muscles syndrome

DEATH
• Chemotherapy
High numbers of WBC
• Blood Transfusion
infiltrate the organs and other
bone marrow failure
parts of the body bones

Lungs crackles

Production of
Enlargement of the blood sputum
Kidneys
forming organs (liver, spleen)
Abdominal Hepatomegaly Splenomegaly Renal insufficiency Pitting bipedal edema
distention
BARBA, ANNIKA Y.
BSN4
AML PATHOPHYSIOLOGY

Uremia

Legend:

Precipitating factors

Predisposing Treatment

Disease process

Manifestations
BARBA, ANNIKA Y.
BSN4
AML PATHOPHYSIOLOGY