AML Blood film

64 years old lady presented to emergency department with history of coffee ground vomiting and being unwell. She had emergency resuscitation and appeared to be unwell . her vital signs were all stable apart from

Pyrexia of 38.4 C. Blood pressure : normal

Examinations were all unremarkable apart from bibasal crackles on both lower bases

Her urgent blood test results were

HB 64

WCC 360

PLT 172

CRP 389 high

Uresa : 10, Creatinine : 98 (upper limit of normal)

Full clotting screen : all Normal

She was transferred to a ward and a haematologist on call were contacted

she had emergency blood film as per Laboratory criteria which were looked at by biomedical scientist: suggested Acute myeloid leukaemia with over 90% myeloid blast

initial management:


2,Patient is at risk of Leuckostasis

3,Exclude APML (Auer rods on film)

4,Full clotting screen (This patient has risk of DIC)

Emergency transfer to the tertiary facility where emergency leukopheresis can be done

Phone haematology consultant is the most important point of this patient care and should take emergency steps