Acute Leukemia


  • Clonal proliferation of hematopoietic progenitor with failed differentiation into mature elements → ↑ blasts in bone marrow and periphery → ↓ RBCs, platelets, and neutrophils

Epidemiology and risk factors

  • Acute myelogenous (AML): ~20k cases/y in U.S.; median age 68 y
  • Acute lymphocytic (ALL): ~6k cases/y in U.S.; median age 15 y but 2nd peak in older adults
  • Risk factors: radiation, chemo (alkylating agents, topo II inhib), benzene, smoking, ? rising from acquired somatic mutations and clonal hematopoiesis (NEJM 2014;371:2477)
  • Secondary to acquired hematopoietic dis.: MDS, esp. CML), aplastic anemia, PNH