Acute Myelogenous Leukemia (AML) is one of several types of cancer of the cells in the blood and bone marrow (the tissue in the center of bones which makes blood). AML is a cancer where immature blood cells reproduce in an uncontrolled manner. DNA normally controls how the cells grow and reproduce. In AML, the DNA of these cells has a mutation that allows them to grow and reproduce at a very high rate. Instead of dying like a normal cell would, these cells live a particularly long time. Normal, healthy blood cells which are usually produced in the bone marrow get crowded and no longer can reproduce normally. “Acute” in the name of the disease refers to the disease coming on and progressing very quickly. “Myelogenous” refers to the type of blood cells which grow out of control in this disease, myeloid cells, a type of white blood cell which grows up to become other blood cells. “Leukemia” refers to this being a cancer of white blood cells. Risk factors for ALL include: previous radiation, previous chemical exposures (especially benzene), previous chemotherapy, age older than 60, being a man, smoking, having other blood disorders, and having some genetic disorders like Down Syndrome.
Infections, nosebleeds, gum bleeding, fever, loss of appetite, shortness of breath, weakness, fatigue, weight loss, bone paint, joint pain
The diagnosis of AML is made by checking several tests. First, a blood sample is taken which can show too many white blood cells and/or young, immature white blood cells that are not normally in the blood, called blast cells. This blood test can also show too few red blood cells or platelets (the other cells that come from the bone marrow). If a problem with the blood (like leukemia) is suspected, a procedure is done to look at the bone marrow called a bone marrow biopsy. The biopsy involves making a small hole with a needle in part of the hip bone to take out bone marrow cells. This procedure is used to diagnose the cancer and to follow how the bone marrow is doing with treatment. Your oncologist (cancer doctor) may want to do some additional testing like taking X-rays or CT scan pictures of the body to determine if and to where the cancer has spread. The subtype of AML is determined based on maturity level f the cells in the bone marrow, how different they appear from the normal cells, the changes and number of changes in the DNA of the cancer cells. The subtype is important information for both prognosis and treatment of the cancer.
AML can be treated with chemotherapy, immunotherapy, other types of drugs, and bone marrow transplant. For AML, treatment is done in two phases: remission induction therapy (first phase, to kill the cancerous cells) and consolidation or maintenance therapy (second phase, to get rid of any remaining cells and prevent relapse). Induction therapy can sometimes does not take the first time and needs to be repeated a few times to achieve remission. Induction chemotherapy usually is done in a hospital because blood cell counts can fall very low and need to be closely monitored. The chemotherapy also causes white blood cell levels to fall very low which makes the patient prone to infections. Depending on the genetic type of AML a person has, more targeted drug therapies may also be available. For promyelocytic types of AML, two such drugs, arsenic trioxide (Trisenox) and all-trans retinoic acid (ATRA) can be used alone or with chemotherapy. Immunotherapy, sometimes called biologic therapy, is available to help improve the ability of the person’s immune system to fight cancer. When other treatments are not successful or are likely to not be successful, bone marrow transplant can be used to treat AML. Chemotherapy or radiation is used to get rid of the cancerous cells in the bone marrow followed by returning other bone marrow cells to that marrow to create new, healthy bone marrow. The donor for the bone marrow can either be someone else or the patient’s own marrow if it is harvested in a time when their cancer is in remission.
