Acute myeloid leukemia (AML), also known as acute myelogenous leukemia, acute non-lymphocytic leukemia, acute granulocytic leukemia and acute myelocytic leukemia, is a cancer of the blood and bone marrow (the soft tissue inside bones where cells are produced). Though AML begins within the bone marrow, it has also been known to spread into the liver, lymph nodes, spleen, testes, spinal cord and brain. One of the most common cancers among adults, it is labeled as an acute disease because of its quick development and progression. Affecting immature cells, AML affects myeloid cells, a group of white blood cells that normally grow into mature cells such as platelets and red blood cells. If left untreated, AML can be fatal within months of development.
Acute Myeloid Leukemia Risk Factors
While DNA damage is the cause of acute myeloid leukemia, the cause a specific patient’s case cannot always be determined. However, there are a number of potential causes, as well as factors that can increase a person’s likelihood of developing AML:
Radiation: Exposure to radiation has been known to lead to AML.
Chemotherapy: Certain chemotherapy drugs, such as etoposide and alkylating agents, can increase the risk of developing AML.
Chemical Exposure: Chemicals such as benzene may pose as a risk.
Smoking: As benzene is a chemical in ciggarettes, smoking is linked to AML development.
Age: People over 40 are more likely to develop AML, with 65 being the average patient age.
Gender: Men are at a higher risk for development than women.
Genetics: Genetic disorders such as Down Syndrom may increase risk.
Immunosuppression: A weak immune system, resulting from an organ transplant, can increase risk.
Blood Disorders: Patients with myelodysplasia (or refractory anemia), polycythemia vera, or essential thrombocythemia have a higher risk of developing AML.
AML is not believed to be an inherited disease. Many people who develop AML have no risk factors.
Acute Myeloid Leukemia Signs and Symptoms
Early symptoms of acute myeloid leukemia are similar to those of the common flu. An important difference between the two is that while flu symptoms will pass over a brief time period, AML symptoms will persist, and even worsen. Symptoms may vary depending on what kinds of blood cells are affected.
These symptoms may include:
- Bruising Easily
- Weight Loss
- Frequent Infections
- Abnormal Menstuation
- Pale Skin
- Fever
- Unexplained or Unusual Bleeding: Nosebleeds and bleeding from the gums may be symptoms.
- Fatigue, Weakness or Lethargy
- Skin Lesion or Rash
- Shortness of Breath: This may also worsen with exercise.
- Bone Pain or Tenderness
- Gum Swelling: This symptom is rare
Acute Myeloid Leukemia Diagnosis
If symptoms for acute myeloid leukemia persist, a doctor may recommend several tests:
Physical Exam: A swollen liver, spleen or lymph nodes may be indicative of the disease.
A CBC (Complete Blood Count): This will show if anemia is present, as well as if the patient’s platelet count is low.
Bone Marrow Aspiration: This will be used to determine if actual leukemia cells are present. It is conducted through removing a small amount of bone marrow from the hipbone with a needle. This procedure can be done in a doctor’s office.
If AML is discovered, more testing may be conducted to determine which specific type the patient has.
Acute Myeloid Leukemia Treatment
Treatment for acute myeloid leukemia, like treatment for most cancers, is centered on killing as many cancerous cells as possible. Depending on the stage of AML the patient is in, treatment may include:
Chemotherapy: This treatment uses chemicals to kill as many cancer cells as possible.
Bone Marrow or Stem Cell Transplant: These transplants may be used to replace unhealthy cells with normal, cancer-free cells or bone marrow.
Biological Therapy, or Immunotherapy: This treatment involves giving the body substances to aid it in its own defense against cancer, such as monoclonal antibodies, which help attack foreign substances within the body.
Red Blood Cell Transfusion: This is used to combat anemia if it occurs.
Platelet Transfusion: This transfusion is given to control bleeding.
Antibiotics: These are primarily used to treat infections.
If a patient has a form of AML called acute promyelocytic leukemia (APL), a drug treatment will be given using all-trans retinoic acid (ATRA), which aids leukemia cells in developing into normal white blood cells. If this treatment proves unsuccessful, the drug arsenic trioxide may be used.
Acute Myeloid Leukemia Outlook (Prognosis)
Overall survival rate is 50% for those who go into complete remission; for overall patients, the rate is 30%. Young patients have a higher survival rate than older patients, mainly because younger bodies are able to tolerate treatments more easily than older ones.
Acute Myeloid Leukemia Prevention
Refraining from smoking (or stopping smoking) and wearing protective gear around radiation or chemicals, or avoiding such substances altogether, are the only real preventions for acute myeloid leukemia.
Resources
Mayo Foundation for Medical Education and Research (MFMER). 1998-2009. Retrieved May 1, 2009 from.
American Cancer Society (ACS). August 3, 2007. Retrieved May 1, 2009 from.
Medline Plus (U.S. National Library of Medicine). 1997-2009. Retrieved May 1, 2009 from.
Cleveland Clinic Center for Continuing Education. 2000-2009. Retrieved May 1, 2009 from.