Gargaz/Test · Datasets at Hugging Face

text stringlengths 8 3.87k
166.01113891601562 51 WikiText2
2550 = = = Names = = =
184.80799865722656 7 WikiText2
2551 The favoured name for this species among naturalists has changed over the years , with " landrail " and variants of " corncrake " being preferred at various times . " Crake gallinule " also had a period of popularity between 1768 and 1813 . The originally Older Scots " cornecrake " was popularised by Thomas Bewick , who used this term in his 1797 A History of British Birds . Other Scots names include " corn scrack " and " quailzie " ; the latter term , like " king of the quail " , " grass quail " , the French " roi de caille " , and the German " Wachtelkönig " refer to the association with the small gamebird . Another name , " daker " , has been variously interpreted as onomatopoeic , or derived from the Old Norse ager @-@ hoene , meaning " cock of the field " ; variants include " drake " , " drake Hen " and " gorse drake " .
46.51192855834961 174 WikiText2
2552 = = = In literature = = =
202.20091247558594 8 WikiText2
2553 Corn crakes are the subject of three stanzas of the seventeenth century poet Andrew Marvell 's " Upon Appleton House " , written in 1651 about the North Yorkshire country estate of Thomas Fairfax . The narrator depicts the scene of a mower cutting the grass , before his " whistling Sithe " unknowingly " carves the Rail " . The farmhand draws out the scythe " all bloody from its breast " and " does the stroke detest " . It continues with a stanza that demonstrates the problematic nature of the corn crake 's nesting habits :
98.70116424560547 99 WikiText2
2554 John Clare , the nineteenth @-@ century English poet based in Northamptonshire , wrote " The Landrail " , a semi @-@ comic piece which is primarily about the difficulty of seeing corn crakes – as opposed to hearing them . In the fourth verse he exclaims : " Tis like a fancy everywhere / A sort of living doubt " . Clare wrote about corn crakes in his prose works too , and his writings help to clarify the distribution of this rail when it was far more widespread than now .
101.48104858398438 97 WikiText2
2555 The Finnish poet Eino Leino also wrote about the bird in his poem " Nocturne " .
71.42654418945312 17 WikiText2
2556 The proverbial use of the corn crake 's call to describe someone with a grating or unmelodious voice is illustrated in the quotation " thanks to a wee woman with a voice like a corncrake who believed she was an apprentice angel " . This usage dates from at least the first half of the nineteenth century , and continues through to the present .
83.21334075927734 65 WikiText2
2557 = Acute myeloid leukemia =
191.7976837158203 5 WikiText2
2558 Acute myeloid leukemia ( AML ) , also known as acute myelogenous leukemia or acute nonlymphocytic leukemia ( ANLL ) , is a cancer of the myeloid line of blood cells , characterized by the rapid growth of abnormal white blood cells that accumulate in the bone marrow and interfere with the production of normal blood cells . AML is the most common acute leukemia affecting adults , and its incidence increases with age . Although AML is a relatively rare disease , accounting for roughly 1 @.@ 2 % of cancer deaths in the United States , its incidence is expected to increase as the population ages .
12.621679306030273 111 WikiText2
2559 The symptoms of AML are caused by replacement of normal bone marrow with leukemic cells , which causes a drop in red blood cells , platelets , and normal white blood cells . These symptoms include fatigue , shortness of breath , easy bruising and bleeding , and increased risk of infection . Several risk factors and chromosomal abnormalities have been identified , but the specific cause is not clear . As an acute leukemia , AML progresses rapidly and is typically fatal within weeks or months if left untreated .
21.78457260131836 91 WikiText2
2560 AML has several subtypes ; treatment and prognosis vary among subtypes . AML is cured in 35 – 40 % of people less than 60 years old and 5 – 15 % more than 60 years old . Older people who are not able to withstand intensive chemotherapy have an average survival of 5 – 10 months .
37.582427978515625 58 WikiText2
2561 AML is treated initially with chemotherapy aimed at inducing a remission ; people may go on to receive additional chemotherapy or a hematopoietic stem cell transplant . Recent research into the genetics of AML has resulted in the availability of tests that can predict which drug or drugs may work best for a particular person , as well as how long that person is likely to survive . The treatment and prognosis of AML differ from those of chronic myelogenous leukemia ( CML ) in part because the cellular differentiation is not the same ; AML involves higher percentages of dedifferentiated and undifferentiated cells , including more blasts ( myeloblasts , monoblasts , and megakaryoblasts ) .
27.322404861450195 117 WikiText2
2562 = = Signs and symptoms = =
610.6599731445312 7 WikiText2
2563 Most signs and symptoms of AML are caused by the replacement of normal blood cells with leukemic cells . A lack of normal white blood cell production makes people more susceptible to infections ; while the leukemic cells themselves are derived from white blood cell precursors , they have no infection @-@ fighting capacity . A drop in red blood cell count ( anemia ) can cause fatigue , paleness , and shortness of breath . A lack of platelets can lead to easy bruising or bleeding with minor trauma .
30.54694175720215 93 WikiText2
2564 The early signs of AML are often vague and nonspecific , and may be similar to those of influenza or other common illnesses . Some generalized symptoms include fever , fatigue , weight loss or loss of appetite , shortness of breath , anemia , easy bruising or bleeding , petechiae ( flat , pin @-@ head sized spots under the skin caused by bleeding ) , bone and joint pain , and persistent or frequent infections .
39.98306655883789 80 WikiText2
2565 Enlargement of the spleen may occur in AML , but it is typically mild and asymptomatic . Lymph node swelling is rare in AML , in contrast to acute lymphoblastic leukemia . The skin is involved about 10 % of the time in the form of leukemia cutis . Rarely , Sweet 's syndrome , a paraneoplastic inflammation of the skin , can occur with AML .
34.48670959472656 67 WikiText2
2566 Some people with AML may experience swelling of the gums because of infiltration of leukemic cells into the gum tissue . Rarely , the first sign of leukemia may be the development of a solid leukemic mass or tumor outside of the bone marrow , called a chloroma . Occasionally , a person may show no symptoms , and the leukemia may be discovered incidentally during a routine blood test .
38.15919494628906 71 WikiText2
2567 = = Risk factors = =
794.2919921875 6 WikiText2
2568 A number of risk factors for developing AML have been identified , including : other blood disorders , chemical exposures , ionizing radiation , and genetics .
44.797203063964844 27 WikiText2
2569 = = = Preleukemia = = =
292.36492919921875 7 WikiText2
2570 " Preleukemic " blood disorders , such as myelodysplastic syndrome ( MDS ) or myeloproliferative disease ( MPS ) , can evolve into AML ; the exact risk depends on the type of MDS / MPS .
37.872764587402344 37 WikiText2
2571 = = = Chemical exposure = = =
300.3633117675781 8 WikiText2
2572 Exposure to anticancer chemotherapy , in particular alkylating agents , can increase the risk of subsequently developing AML . The risk is highest about three to five years after chemotherapy . Other chemotherapy agents , specifically epipodophyllotoxins and anthracyclines , have also been associated with treatment @-@ related leukemias , which are often associated with specific chromosomal abnormalities in the leukemic cells .
41.70050048828125 65 WikiText2
2573 Occupational chemical exposure to benzene and other aromatic organic solvents is controversial as a cause of AML . Benzene and many of its derivatives are known to be carcinogenic in vitro . While some studies have suggested a link between occupational exposure to benzene and increased risk of AML , others have suggested the attributable risk , if any , is slight .
19.029335021972656 63 WikiText2
2574 = = = Radiation = = =
203.8185577392578 7 WikiText2
2575 High amounts of ionizing radiation exposure can increase the risk of AML . Survivors of the atomic bombings of Hiroshima and Nagasaki had an increased rate of AML , as did radiologists exposed to high levels of X @-@ rays prior to the adoption of modern radiation safety practices . People treated with ionizing radiation after treatment for prostate cancer , non @-@ Hodgkin lymphoma , lung cancer and breast cancer have the highest chance of acquiring AML , but this increased risk returns to the background risk observed in the general population after 12 years .
31.17331886291504 101 WikiText2
2576 = = = Genetics = = =
194.1599884033203 7 WikiText2
2577 A hereditary risk for AML appears to exist . Multiple cases of AML developing in a family at a rate higher than predicted by chance alone have been reported . Several congenital conditions may increase the risk of leukemia ; the most common is probably Down syndrome , which is associated with a 10- to 18 @-@ fold increase in the risk of AML .
41.064720153808594 67 WikiText2
2578 = = Diagnosis = =
416.00048828125 5 WikiText2
2579 The first clue to a diagnosis of AML is typically an abnormal result on a complete blood count . While an excess of abnormal white blood cells ( leukocytosis ) is a common finding , and leukemic blasts are sometimes seen , AML can also present with isolated decreases in platelets , red blood cells , or even with a low white blood cell count ( leukopenia ) . While a presumptive diagnosis of AML can be made by examination of the peripheral blood smear when there are circulating leukemic blasts , a definitive diagnosis usually requires an adequate bone marrow aspiration and biopsy .
26.341272354125977 105 WikiText2
2580 Marrow or blood is examined under light microscopy , as well as flow cytometry , to diagnose the presence of leukemia , to differentiate AML from other types of leukemia ( e.g. acute lymphoblastic leukemia - ALL ) , and to classify the subtype of disease . A sample of marrow or blood is typically also tested for chromosomal abnormalities by routine cytogenetics or fluorescent in situ hybridization . Genetic studies may also be performed to look for specific mutations in genes such as FLT3 , nucleophosmin , and KIT , which may influence the outcome of the disease .
28.502010345458984 101 WikiText2
2581 Cytochemical stains on blood and bone marrow smears are helpful in the distinction of AML from ALL , and in subclassification of AML . The combination of a myeloperoxidase or Sudan black stain and a nonspecific esterase stain will provide the desired information in most cases . The myeloperoxidase or Sudan black reactions are most useful in establishing the identity of AML and distinguishing it from ALL . The nonspecific esterase stain is used to identify a monocytic component in AMLs and to distinguish a poorly differentiated monoblastic leukemia from ALL .
30.56650161743164 92 WikiText2
2582 The diagnosis and classification of AML can be challenging , and should be performed by a qualified hematopathologist or hematologist . In straightforward cases , the presence of certain morphologic features ( such as Auer rods ) or specific flow cytometry results can distinguish AML from other leukemias ; however , in the absence of such features , diagnosis may be more difficult .
39.10073471069336 64 WikiText2
2583 The two most commonly used classification schemata for AML are the older French @-@ American @-@ British ( FAB ) system and the newer World Health Organization ( WHO ) system . According to the widely used WHO criteria , the diagnosis of AML is established by demonstrating involvement of more than 20 % of the blood and / or bone marrow by leukemic myeloblasts , except in the three best prognosis forms of AML with recurrent genetic abnormalities ( t ( 8 ; 21 ) , inv ( 16 ) , and t ( 15 ; 17 ) ) in which the presence of the genetic abnormality is diagnostic irrespective of blast percent . The French – American – British ( FAB ) classification is a bit more stringent , requiring a blast percentage of at least 30 % in bone marrow ( BM ) or peripheral blood ( PB ) for the diagnosis of AML . AML must be carefully differentiated from " preleukemic " conditions such as myelodysplastic or myeloproliferative syndromes , which are treated differently .
33.31330490112305 184 WikiText2
2584 Because acute promyelocytic leukemia ( APL ) has the highest curability and requires a unique form of treatment , it is important to quickly establish or exclude the diagnosis of this subtype of leukemia . Fluorescent in situ hybridization performed on blood or bone marrow is often used for this purpose , as it readily identifies the chromosomal translocation [ t ( 15 ; 17 ) ( q22 ; q12 ) ; ] that characterizes APL . There is also a need to molecularly detect the presence of PML / RARA fusion protein , which is an oncogenic product of that translocation .
42.917381286621094 103 WikiText2
2585 = = = World Health Organization = = =
119.73468017578125 9 WikiText2
2586 The WHO 2008 classification of acute myeloid leukemia attempts to be more clinically useful and to produce more meaningful prognostic information than the FAB criteria . Each of the WHO categories contains numerous descriptive subcategories of interest to the hematopathologist and oncologist ; however , most of the clinically significant information in the WHO schema is communicated via categorization into one of the subtypes listed below .
57.99291229248047 67 WikiText2
2587 The WHO subtypes of AML are :
598.2247924804688 7 WikiText2
2588 Acute leukemias of ambiguous lineage ( also known as mixed phenotype or biphenotypic acute leukemia ) occur when the leukemic cells can not be classified as either myeloid or lymphoid cells , or where both types of cells are present .
43.17019271850586 41 WikiText2
2589 = = = French @-@ American @-@ British = = =
162.15390014648438 15 WikiText2
2590 The French @-@ American @-@ British ( FAB ) classification system divides AML into eight subtypes , M0 through to M7 , based on the type of cell from which the leukemia developed and its degree of maturity . This is done by examining the appearance of the malignant cells with light microscopy and / or by using cytogenetics to characterize any underlying chromosomal abnormalities . The subtypes have varying prognoses and responses to therapy . Although the WHO classification ( see above ) may be more useful , the FAB system is still widely used .
54.001827239990234 101 WikiText2
2591 Eight FAB subtypes were proposed in 1976 .
440.8848571777344 8 WikiText2
2592 The morphologic subtypes of AML also include rare types not included in the FAB system , such as acute basophilic leukemia , which was proposed as a ninth subtype , M8 , in 1999 .
88.0521011352539 35 WikiText2
2593 = = Pathophysiology = =
511.19476318359375 5 WikiText2
2594 The malignant cell in AML is the myeloblast . In normal hematopoiesis , the myeloblast is an immature precursor of myeloid white blood cells ; a normal myeloblast will gradually mature into a mature white blood cell . In AML , though , a single myeloblast accumulates genetic changes which " freeze " the cell in its immature state and prevent differentiation . Such a mutation alone does not cause leukemia ; however , when such a " differentiation arrest " is combined with other mutations which disrupt genes controlling proliferation , the result is the uncontrolled growth of an immature clone of cells , leading to the clinical entity of AML .
27.47343635559082 113 WikiText2
2595 Much of the diversity and heterogeneity of AML stems is because leukemic transformation can occur at a number of different steps along the differentiation pathway . Modern classification schemes for AML recognize the characteristics and behavior of the leukemic cell ( and the leukemia ) may depend on the stage at which differentiation was halted .
70.12654113769531 56 WikiText2
2596 Specific cytogenetic abnormalities can be found in many people with AML ; the types of chromosomal abnormalities often have prognostic significance . The chromosomal translocations encode abnormal fusion proteins , usually transcription factors whose altered properties may cause the " differentiation arrest " . For example , in acute promyelocytic leukemia , the t ( 15 ; 17 ) translocation produces a PML @-@ RARα fusion protein which binds to the retinoic acid receptor element in the promoters of several myeloid @-@ specific genes and inhibits myeloid differentiation .
61.00973129272461 93 WikiText2
2597 The clinical signs and symptoms of AML result from the growth of leukemic clone cells , which tends to displace or interfere with the development of normal blood cells in the bone marrow . This leads to neutropenia , anemia , and thrombocytopenia . The symptoms of AML are , in turn , often due to the low numbers of these normal blood elements . In rare cases , people with AML can develop a chloroma , or solid tumor of leukemic cells outside the bone marrow , which can cause various symptoms depending on its location .
22.251136779785156 98 WikiText2
2598 An important pathophysiological mechanism of leukemogenesis in AML is the epigenetic induction of dedifferentiation by genetic mutations that alter the function of epigenetic enzymes , such as the DNA demethylase TET2 and the metabolic enzymes IDH1 and IDH2 , which lead to the generation of a novel oncometabolite , D @-@ 2 @-@ hydroxyglutarate , which inhibits the activity of epigenetic enzymes such as TET2 . The hypothesis is that such epigenetic mutations lead to the silencing of tumor suppressor genes and / or the activation of proto @-@ oncogenes .
37.57969284057617 97 WikiText2
2599 = = Treatment = =

166.01113891601562 51 WikiText2

2550 = = = Names = = =

184.80799865722656 7 WikiText2

2551 The favoured name for this species among naturalists has changed over the years , with " landrail " and variants of " corncrake " being preferred at various times . " Crake gallinule " also had a period of popularity between 1768 and 1813 . The originally Older Scots " cornecrake " was popularised by Thomas Bewick , who used this term in his 1797 A History of British Birds . Other Scots names include " corn scrack " and " quailzie " ; the latter term , like " king of the quail " , " grass quail " , the French " roi de caille " , and the German " Wachtelkönig " refer to the association with the small gamebird . Another name , " daker " , has been variously interpreted as onomatopoeic , or derived from the Old Norse ager @-@ hoene , meaning " cock of the field " ; variants include " drake " , " drake Hen " and " gorse drake " .

46.51192855834961 174 WikiText2

2552 = = = In literature = = =

202.20091247558594 8 WikiText2

2553 Corn crakes are the subject of three stanzas of the seventeenth century poet Andrew Marvell 's " Upon Appleton House " , written in 1651 about the North Yorkshire country estate of Thomas Fairfax . The narrator depicts the scene of a mower cutting the grass , before his " whistling Sithe " unknowingly " carves the Rail " . The farmhand draws out the scythe " all bloody from its breast " and " does the stroke detest " . It continues with a stanza that demonstrates the problematic nature of the corn crake 's nesting habits :

98.70116424560547 99 WikiText2

2554 John Clare , the nineteenth @-@ century English poet based in Northamptonshire , wrote " The Landrail " , a semi @-@ comic piece which is primarily about the difficulty of seeing corn crakes – as opposed to hearing them . In the fourth verse he exclaims : " Tis like a fancy everywhere / A sort of living doubt " . Clare wrote about corn crakes in his prose works too , and his writings help to clarify the distribution of this rail when it was far more widespread than now .

101.48104858398438 97 WikiText2

2555 The Finnish poet Eino Leino also wrote about the bird in his poem " Nocturne " .

71.42654418945312 17 WikiText2

2556 The proverbial use of the corn crake 's call to describe someone with a grating or unmelodious voice is illustrated in the quotation " thanks to a wee woman with a voice like a corncrake who believed she was an apprentice angel " . This usage dates from at least the first half of the nineteenth century , and continues through to the present .

83.21334075927734 65 WikiText2

2557 = Acute myeloid leukemia =

191.7976837158203 5 WikiText2

2558 Acute myeloid leukemia ( AML ) , also known as acute myelogenous leukemia or acute nonlymphocytic leukemia ( ANLL ) , is a cancer of the myeloid line of blood cells , characterized by the rapid growth of abnormal white blood cells that accumulate in the bone marrow and interfere with the production of normal blood cells . AML is the most common acute leukemia affecting adults , and its incidence increases with age . Although AML is a relatively rare disease , accounting for roughly 1 @.@ 2 % of cancer deaths in the United States , its incidence is expected to increase as the population ages .

12.621679306030273 111 WikiText2

2559 The symptoms of AML are caused by replacement of normal bone marrow with leukemic cells , which causes a drop in red blood cells , platelets , and normal white blood cells . These symptoms include fatigue , shortness of breath , easy bruising and bleeding , and increased risk of infection . Several risk factors and chromosomal abnormalities have been identified , but the specific cause is not clear . As an acute leukemia , AML progresses rapidly and is typically fatal within weeks or months if left untreated .

21.78457260131836 91 WikiText2

2560 AML has several subtypes ; treatment and prognosis vary among subtypes . AML is cured in 35 – 40 % of people less than 60 years old and 5 – 15 % more than 60 years old . Older people who are not able to withstand intensive chemotherapy have an average survival of 5 – 10 months .

37.582427978515625 58 WikiText2

2561 AML is treated initially with chemotherapy aimed at inducing a remission ; people may go on to receive additional chemotherapy or a hematopoietic stem cell transplant . Recent research into the genetics of AML has resulted in the availability of tests that can predict which drug or drugs may work best for a particular person , as well as how long that person is likely to survive . The treatment and prognosis of AML differ from those of chronic myelogenous leukemia ( CML ) in part because the cellular differentiation is not the same ; AML involves higher percentages of dedifferentiated and undifferentiated cells , including more blasts ( myeloblasts , monoblasts , and megakaryoblasts ) .

27.322404861450195 117 WikiText2

2562 = = Signs and symptoms = =

610.6599731445312 7 WikiText2

2563 Most signs and symptoms of AML are caused by the replacement of normal blood cells with leukemic cells . A lack of normal white blood cell production makes people more susceptible to infections ; while the leukemic cells themselves are derived from white blood cell precursors , they have no infection @-@ fighting capacity . A drop in red blood cell count ( anemia ) can cause fatigue , paleness , and shortness of breath . A lack of platelets can lead to easy bruising or bleeding with minor trauma .

30.54694175720215 93 WikiText2

2564 The early signs of AML are often vague and nonspecific , and may be similar to those of influenza or other common illnesses . Some generalized symptoms include fever , fatigue , weight loss or loss of appetite , shortness of breath , anemia , easy bruising or bleeding , petechiae ( flat , pin @-@ head sized spots under the skin caused by bleeding ) , bone and joint pain , and persistent or frequent infections .

39.98306655883789 80 WikiText2

2565 Enlargement of the spleen may occur in AML , but it is typically mild and asymptomatic . Lymph node swelling is rare in AML , in contrast to acute lymphoblastic leukemia . The skin is involved about 10 % of the time in the form of leukemia cutis . Rarely , Sweet 's syndrome , a paraneoplastic inflammation of the skin , can occur with AML .

34.48670959472656 67 WikiText2

2566 Some people with AML may experience swelling of the gums because of infiltration of leukemic cells into the gum tissue . Rarely , the first sign of leukemia may be the development of a solid leukemic mass or tumor outside of the bone marrow , called a chloroma . Occasionally , a person may show no symptoms , and the leukemia may be discovered incidentally during a routine blood test .

38.15919494628906 71 WikiText2

2567 = = Risk factors = =

794.2919921875 6 WikiText2

2568 A number of risk factors for developing AML have been identified , including : other blood disorders , chemical exposures , ionizing radiation , and genetics .

44.797203063964844 27 WikiText2

2569 = = = Preleukemia = = =

292.36492919921875 7 WikiText2

2570 " Preleukemic " blood disorders , such as myelodysplastic syndrome ( MDS ) or myeloproliferative disease ( MPS ) , can evolve into AML ; the exact risk depends on the type of MDS / MPS .

37.872764587402344 37 WikiText2

2571 = = = Chemical exposure = = =

300.3633117675781 8 WikiText2

2572 Exposure to anticancer chemotherapy , in particular alkylating agents , can increase the risk of subsequently developing AML . The risk is highest about three to five years after chemotherapy . Other chemotherapy agents , specifically epipodophyllotoxins and anthracyclines , have also been associated with treatment @-@ related leukemias , which are often associated with specific chromosomal abnormalities in the leukemic cells .

41.70050048828125 65 WikiText2

2573 Occupational chemical exposure to benzene and other aromatic organic solvents is controversial as a cause of AML . Benzene and many of its derivatives are known to be carcinogenic in vitro . While some studies have suggested a link between occupational exposure to benzene and increased risk of AML , others have suggested the attributable risk , if any , is slight .

19.029335021972656 63 WikiText2

2574 = = = Radiation = = =

203.8185577392578 7 WikiText2

2575 High amounts of ionizing radiation exposure can increase the risk of AML . Survivors of the atomic bombings of Hiroshima and Nagasaki had an increased rate of AML , as did radiologists exposed to high levels of X @-@ rays prior to the adoption of modern radiation safety practices . People treated with ionizing radiation after treatment for prostate cancer , non @-@ Hodgkin lymphoma , lung cancer and breast cancer have the highest chance of acquiring AML , but this increased risk returns to the background risk observed in the general population after 12 years .

31.17331886291504 101 WikiText2

2576 = = = Genetics = = =

194.1599884033203 7 WikiText2

2577 A hereditary risk for AML appears to exist . Multiple cases of AML developing in a family at a rate higher than predicted by chance alone have been reported . Several congenital conditions may increase the risk of leukemia ; the most common is probably Down syndrome , which is associated with a 10- to 18 @-@ fold increase in the risk of AML .

41.064720153808594 67 WikiText2

2578 = = Diagnosis = =

416.00048828125 5 WikiText2

2579 The first clue to a diagnosis of AML is typically an abnormal result on a complete blood count . While an excess of abnormal white blood cells ( leukocytosis ) is a common finding , and leukemic blasts are sometimes seen , AML can also present with isolated decreases in platelets , red blood cells , or even with a low white blood cell count ( leukopenia ) . While a presumptive diagnosis of AML can be made by examination of the peripheral blood smear when there are circulating leukemic blasts , a definitive diagnosis usually requires an adequate bone marrow aspiration and biopsy .

26.341272354125977 105 WikiText2

2580 Marrow or blood is examined under light microscopy , as well as flow cytometry , to diagnose the presence of leukemia , to differentiate AML from other types of leukemia ( e.g. acute lymphoblastic leukemia - ALL ) , and to classify the subtype of disease . A sample of marrow or blood is typically also tested for chromosomal abnormalities by routine cytogenetics or fluorescent in situ hybridization . Genetic studies may also be performed to look for specific mutations in genes such as FLT3 , nucleophosmin , and KIT , which may influence the outcome of the disease .

28.502010345458984 101 WikiText2

2581 Cytochemical stains on blood and bone marrow smears are helpful in the distinction of AML from ALL , and in subclassification of AML . The combination of a myeloperoxidase or Sudan black stain and a nonspecific esterase stain will provide the desired information in most cases . The myeloperoxidase or Sudan black reactions are most useful in establishing the identity of AML and distinguishing it from ALL . The nonspecific esterase stain is used to identify a monocytic component in AMLs and to distinguish a poorly differentiated monoblastic leukemia from ALL .

30.56650161743164 92 WikiText2

2582 The diagnosis and classification of AML can be challenging , and should be performed by a qualified hematopathologist or hematologist . In straightforward cases , the presence of certain morphologic features ( such as Auer rods ) or specific flow cytometry results can distinguish AML from other leukemias ; however , in the absence of such features , diagnosis may be more difficult .

39.10073471069336 64 WikiText2

2583 The two most commonly used classification schemata for AML are the older French @-@ American @-@ British ( FAB ) system and the newer World Health Organization ( WHO ) system . According to the widely used WHO criteria , the diagnosis of AML is established by demonstrating involvement of more than 20 % of the blood and / or bone marrow by leukemic myeloblasts , except in the three best prognosis forms of AML with recurrent genetic abnormalities ( t ( 8 ; 21 ) , inv ( 16 ) , and t ( 15 ; 17 ) ) in which the presence of the genetic abnormality is diagnostic irrespective of blast percent . The French – American – British ( FAB ) classification is a bit more stringent , requiring a blast percentage of at least 30 % in bone marrow ( BM ) or peripheral blood ( PB ) for the diagnosis of AML . AML must be carefully differentiated from " preleukemic " conditions such as myelodysplastic or myeloproliferative syndromes , which are treated differently .

33.31330490112305 184 WikiText2

2584 Because acute promyelocytic leukemia ( APL ) has the highest curability and requires a unique form of treatment , it is important to quickly establish or exclude the diagnosis of this subtype of leukemia . Fluorescent in situ hybridization performed on blood or bone marrow is often used for this purpose , as it readily identifies the chromosomal translocation [ t ( 15 ; 17 ) ( q22 ; q12 ) ; ] that characterizes APL . There is also a need to molecularly detect the presence of PML / RARA fusion protein , which is an oncogenic product of that translocation .

42.917381286621094 103 WikiText2

2585 = = = World Health Organization = = =

119.73468017578125 9 WikiText2

2586 The WHO 2008 classification of acute myeloid leukemia attempts to be more clinically useful and to produce more meaningful prognostic information than the FAB criteria . Each of the WHO categories contains numerous descriptive subcategories of interest to the hematopathologist and oncologist ; however , most of the clinically significant information in the WHO schema is communicated via categorization into one of the subtypes listed below .

57.99291229248047 67 WikiText2

2587 The WHO subtypes of AML are :

598.2247924804688 7 WikiText2

2588 Acute leukemias of ambiguous lineage ( also known as mixed phenotype or biphenotypic acute leukemia ) occur when the leukemic cells can not be classified as either myeloid or lymphoid cells , or where both types of cells are present .

43.17019271850586 41 WikiText2

2589 = = = French @-@ American @-@ British = = =

162.15390014648438 15 WikiText2

2590 The French @-@ American @-@ British ( FAB ) classification system divides AML into eight subtypes , M0 through to M7 , based on the type of cell from which the leukemia developed and its degree of maturity . This is done by examining the appearance of the malignant cells with light microscopy and / or by using cytogenetics to characterize any underlying chromosomal abnormalities . The subtypes have varying prognoses and responses to therapy . Although the WHO classification ( see above ) may be more useful , the FAB system is still widely used .

54.001827239990234 101 WikiText2

2591 Eight FAB subtypes were proposed in 1976 .

440.8848571777344 8 WikiText2

2592 The morphologic subtypes of AML also include rare types not included in the FAB system , such as acute basophilic leukemia , which was proposed as a ninth subtype , M8 , in 1999 .

88.0521011352539 35 WikiText2

2593 = = Pathophysiology = =

511.19476318359375 5 WikiText2

2594 The malignant cell in AML is the myeloblast . In normal hematopoiesis , the myeloblast is an immature precursor of myeloid white blood cells ; a normal myeloblast will gradually mature into a mature white blood cell . In AML , though , a single myeloblast accumulates genetic changes which " freeze " the cell in its immature state and prevent differentiation . Such a mutation alone does not cause leukemia ; however , when such a " differentiation arrest " is combined with other mutations which disrupt genes controlling proliferation , the result is the uncontrolled growth of an immature clone of cells , leading to the clinical entity of AML .

27.47343635559082 113 WikiText2

2595 Much of the diversity and heterogeneity of AML stems is because leukemic transformation can occur at a number of different steps along the differentiation pathway . Modern classification schemes for AML recognize the characteristics and behavior of the leukemic cell ( and the leukemia ) may depend on the stage at which differentiation was halted .

70.12654113769531 56 WikiText2

2596 Specific cytogenetic abnormalities can be found in many people with AML ; the types of chromosomal abnormalities often have prognostic significance . The chromosomal translocations encode abnormal fusion proteins , usually transcription factors whose altered properties may cause the " differentiation arrest " . For example , in acute promyelocytic leukemia , the t ( 15 ; 17 ) translocation produces a PML @-@ RARα fusion protein which binds to the retinoic acid receptor element in the promoters of several myeloid @-@ specific genes and inhibits myeloid differentiation .

61.00973129272461 93 WikiText2

2597 The clinical signs and symptoms of AML result from the growth of leukemic clone cells , which tends to displace or interfere with the development of normal blood cells in the bone marrow . This leads to neutropenia , anemia , and thrombocytopenia . The symptoms of AML are , in turn , often due to the low numbers of these normal blood elements . In rare cases , people with AML can develop a chloroma , or solid tumor of leukemic cells outside the bone marrow , which can cause various symptoms depending on its location .

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2598 An important pathophysiological mechanism of leukemogenesis in AML is the epigenetic induction of dedifferentiation by genetic mutations that alter the function of epigenetic enzymes , such as the DNA demethylase TET2 and the metabolic enzymes IDH1 and IDH2 , which lead to the generation of a novel oncometabolite , D @-@ 2 @-@ hydroxyglutarate , which inhibits the activity of epigenetic enzymes such as TET2 . The hypothesis is that such epigenetic mutations lead to the silencing of tumor suppressor genes and / or the activation of proto @-@ oncogenes .

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2599 = = Treatment = =