Acute Myelogenous Leukemia (AML): Symptoms, Treatments & Medications
Synopsis: General information regarding Acute myelogenous leukemia (AML), a cancer of the bone marrow and blood.1
Author: Thomas C. Weiss Contact: Disabled World
Acute myelogenous leukemia (AML) is a cancer of a person's bone marrow and blood. Bone marrow is the spongy tissue inside bones where blood cells are created. The word, 'acute,' in acute myelogenous leukemia concerns the rapid progression of the disease. It is called, 'myelogenous,' leukemia because it affects a group of white blood cells called the, 'myeloid,' cells which usually develop into the different types of mature blood cells such as red blood cells, platelets and white blood cells. Acute myelogenous leukemia is also referred to as:
Acute myeloid leukemia (AML), also known as acute myelogenous leukemia or acute nonlymphocytic leukemia (ANLL), is defined as 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.
- Acute myeloid leukemia
- Acute granulocytic leukemia
- Acute myeloblastic leukemia
- Acute nonlymphocytic leukemia
General signs and symptoms of the early stages of acute myelogenous leukemia might mimic those of the flu or other diseases that are common. Signs and symptoms can vary based upon the type of blood cell affected. Signs and symptoms of AML include the following:
- Pale skin
- Bone pain
- Easy bruising
- Frequent infections
- Shortness of breath
- Lethargy and fatigue
- Unusual bleeding, such as frequent nosebleeds and bleeding from the gums
Acute myelogenous leukemia (AML) is caused by damage to the DNA of developing cells in a person's bone marrow. When this occurs, blood cell production becomes something it should not be. The bone marrow produces immature cells that develop into leukemic white blood cells called, 'myeloblasts.' Myeloblasts are unable to function appropriately and they may build up and crowd out cells that are healthy.
In most instances, it is not clear what causes the DNA mutations that lead to leukemia. Radiation, some chemotherapy drugs and certain chemicals are known risk factors for AML.
AML Risk factors
Some different factors exist that might increase a person's risk of acute myelogenous leukemia (AML). Among these risk factors are the ones presented below.
Gender: Men are more likely to develop AML than women are.
Genetic Disorders: Certain genetic disorders such as Down syndrome are associated with an increased risk of AML.
Exposure to Dangerous Chemicals: Exposure to some chemicals such as benzene is linked to increased risk of AML.
Smoking: AML is linked to cigarette smoke, which contains benzene and additional, known cancer-causing chemicals.
Age: The risk of acute myelogenous leukemia increases as a person ages. AML is most common in adults who are age 65 and older.
Prior Cancer Treatment: People who have received certain types of radiation therapy and chemotherapy might experience and increased risk of developing AML.
Additional Blood Disorders: People who have experienced another blood disorder such as polycythemia, myelodysplasia, or thrombocythemia are at increased risk of developing AML.
Radiation Exposure: People who are exposed to very high levels of radiation have an increased risk of developing AML. For example; survivors of a nuclear accident experience this risk.
A number of people with AML have no known risk factors. It is important to note this fact, as well as the fact that many people who have risk factors for AML never go on to develop this form of cancer.
AML Tests and Diagnosis
A doctor might recommend a person undergo diagnostic tests if they present with signs or symptoms of acute myelogenous leukemia (AML). The tests may include the following.
Lumbar Puncture: In some instances, it might be necessary to remove some of the fluid around a person's spinal cord in order to check for leukemia cells. A person's doctor can collect the fluid by inserting a small needle into the person's spinal canal in their lower back.
Bone Marrow Test: A blood test can suggest leukemia, yet it usually takes a bone marrow test to confirm a diagnosis. During a bone marrow biopsy, a needle is used to obtain a sample of a person's bone marrow. The sample is usually taken from the person's hip bone; the sample is then sent to a laboratory for testing.
Blood Testing: The majority of people with AML have too many white blood cells, a lack of adequate numbers of platelets, as well as a lack of adequate numbers of red blood cells. The presence of, 'blast cells,' or immature cells usually found in bone marrow, yet not found in blood that is circulating, is another indicator of AML.
If a doctor suspects leukemia, the person might be referred to a doctor who specializes in cancer, or a doctor who specializes in blood and blood-forming tissues.
If a doctor determines that a person has AML, the person might require additional testing to determine the extent of the cancer and to classify it into a more specific AML subtype. A person's AML subtype is based on how their cells appear when they are examined underneath a microscope. Certain laboratory testing may also be used to identify the particular characteristics of the person's cells. A person's AML subtype helps to determine which types of treatments might be best for them. Doctors are studying how different types of cancer treatments affect people with different AML types.
AML Treatments and Medications
Treatment of acute myelogenous leukemia (AML) depends on a number of factors, to include the subtype of the disease, the person's overall health and age, as well as the person's preferences. Generally, treatment falls into two phases which are described below.
Remission Induction Therapy: The purpose of the first phase of treatment is to kill the leukemia cells in a person's blood and bone marrow. Remission induction therapy; however, does not kill all of the leukemia cells so the person will require additional treatment to prevent the disease from returning.
Consolidation Therapy: Consolidation therapy is also referred to as, 'maintenance therapy,' post-remission therapy,' or, 'intensification.' In this phase of treatment, the goal is to destroy remaining leukemia cells. It is considered to be crucial in order to decrease the risk of relapse.
During these phases, some different types of therapies are used. These types of therapies include:
Clinical Trials: Some people with leukemia choose to enroll in clinical trials to attempt experimental types of treatments, or new combinations of known therapies.
Other Medication Therapy: Arsenic trioxide and all-trans retinoic acid (ATRA) are anti-cancer medications that may be used alone or in combination with chemotherapy for remission induction of a certain subtype of AML called, 'promyelocytic leukemia.' The medications cause leukemia cells with a specific gene mutation to mature and then die, or to cease dividing.
Chemotherapy: Chemotherapy is the major type of remission induction therapy, although it may also be used for consolidation therapy. Chemotherapy uses chemicals to kill cancer cells in a person's body. People with AML usually remain in the hospital during chemotherapy treatments because the medications destroy many usual blood cells in the process of killing leukemia ones. If the first cycle of chemotherapy does not cause remission, it might be repeated.
Stem Cell Transplant: A stem cell transplant also called a bone marrow transplant, might be used for consolidation therapy. A stem cell transplant helps to re-establish healthy stem cells by replacing unhealthy bone marrow with leukemia-free stem cells that will regenerate healthy bone marrow. Before a stem cell transplant, the person receives very high doses of radiation therapy or chemotherapy to destroy their leukemia-producing bone marrow. The person then receives infusions of stem cells from a compatible donor called an, 'allogeneic transplant.' A person may also receive their own stem cells if they were previously in remission and had their healthy stem cells removed and stored for a future transplant.
- Although AML is currently a relatively rare disease, accounting for approximately 1.2% of cancer deaths in the United States, its incidence is expected to increase as the population ages.
- Acute myeloid leukemia is a curable disease; the chance of cure for a specific patient depends on a number of prognostic factors.
- A number of risk factors for developing AML have been identified, including: other blood disorders, chemical exposures, ionizing radiation, and genetics.
- AML has several subtypes; treatment and prognosis varies among subtypes. AML is cured in 35-40% of patients 60 years old and 5 to 15% >60 years old. Older patients who are not able to withstand intensive chemotherapy have a median survival of 5 to 10 months.
- There are approximately 10,500 new cases each year in the United States, and the incidence rate has remained stable from 1995 through 2005.
- AML accounts for 1.2% of all cancer deaths in the United States.
- The incidence of AML increases with age; the median age at diagnosis is 63 years.
- AML accounts for about 90% of all acute leukemias in adults, but is rare in children.
- The rate of therapy-related AML (that is, AML caused by previous chemotherapy) is rising; therapy-related disease currently accounts for about 10 to 20% of all cases of AML.
- AML is slightly more common in men, with a male-to-female ratio of 1.3:1.
- In adults, the highest rates are seen in North America, Europe, and Oceania, while adult AML is rarer in Asia and Latin America. In contrast, childhood AML is less common in North America and India than in other parts of Asia. These differences may be due to population genetics, environmental factors, or a combination of the two.
- AML accounts for 34% of all leukaemia cases in the UK, and around 2,900 people were diagnosed with the disease in 2011.
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