Acute Undifferentiated Leukemia
(AUL) In Adults

Introduction:

This type of acute adult leukemia is much less common than ALL and AML. It is therefore more difficult to get enough cases to do controlled clinical trials. The diagnosis is made by way of exclusion. The following "formula" helps to visualize this relationship.

 

 

AUL= (acute adult leukemia) - ALL - AML

 

 

In other words, it seems that AUL is what is left when all the adult ALL and adult AML cases are subtracted from all of the acute adult leukemia cases.

In AUL there are more immature bone marrow cells present, which might have growth rate that is very fast resulting in a poor prognosis. However, as there are subtypes, it is best to seek the advice of a hematologist in order to have this acute leukemia characterized utilizing various tests and to have this condition treated early with the most appropriate therapy.

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Symptoms:

Due to the prolifertation of abnormal white blood cells in the bone marrow of patients with AUL, red blood cell production in the bone marrow is relatively poor leading to leukemia symptoms of weakness and fatigue (from anemia). The patient may look very pale. Other blood cells such as granulocyte counts are also missing or very low making the patients very prone to infection. The blood platelets (=thrombocytes) are the third cell population in the bone marrow that is suffering from the overwhelming production of the cancerous white blood cells and as a result bleeding occurs frequently in patients with AUL. Tooth flossing can lead to bleeding gums. Minor bumps on the skin can lead to hematomas.

Diagnostic tests:

The first step the physician likely will take is to order a leukemia blood test with a blood smear.

This will show the total amount of white blood cells, which may show abnormally high or low cell counts. The blood smear will show immature forms with different complicated names, which are immaterial for the non-hematologist. After this abnormal test the treating physician will likely refer to a specialist (hematologist) who will likely perform a bone marrow aspirate and/or bone marrow biopsy for making the final diagnosis of the acute undifferentiated leukemia.

Treatment:

As stated above, this is a very rapidly dividing form of acute leukemia and the cancer cells are immature. Combination chemotherapy is usually used to suppress the leukemia. Platelet transfusion and blood transfusion may also have to be given for a period of time. A bone marrow transplant may have to be considered. In case of infections antibiotic therapy may have to be given as well.

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Disclaimer:

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.

References:

1. Cancer: Principles &Practice of Oncology. 4th edition. Edited by Vincent T. DeVita, Jr. et al. Lippincott, Philadelphia,PA, 1993. Chapter on Acute Leukemia.

2. Cancer: Principles&Practice of Oncology. 5th edition, volume 2. Edited by Vincent T. DeVita, Jr. et al. Lippincott-Raven Publ., Philadelphia,PA, 1997. Chapter on Acute Leukemia.

3. Conn's Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier

4. Ferri: Ferri's Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc

Last Modified: Aug. 3, 2012