What is Acute Myeloid Leukemia?
Acute myeloid leukemia (AML) is a type of cancer that starts in the bone marrow and leads to an overproduction of immature white blood cells called myeloblasts, monoblasts, or monocytes. In AML, the unhealthy cells flood the bone marrow and interfere with the production of normal white blood cells, red blood cells, and platelets. This process is called leukemogenesis. AML occurs when a person’s bone marrow becomes overwhelmed by abnormal white blood cells that are unable to properly mature or function.
Signs and Symptoms of AML
The signs and symptoms of AML vary depending on the person but may include:
– Fatigue and weakness due to anemia from low red blood cell counts. This leads to pale skin, dizziness, and shortness of breath.
– Frequent infections from low white blood cell counts. This occurs as there are fewer healthy white blood cells to fight infection.
– Easy bleeding or bruising from low platelet counts. This happens since platelets help the blood to clot normally.
– Weight loss and loss of appetite.
– Fever and chills due to infection.
– Bone pain or tenderness may occur if leukemia cells collect in the bone or bone marrow.
– Swollen or bleeding gums.
– Enlarged lymph nodes, liver, or spleen.
– Small red or purple spots under the skin.
Causes and Risk Factors
While the exact cause of Acute Myeloid Leukemia (AML) is unknown in most cases, there are some known risk factors that may increase a person’s likelihood of developing the disease:
– Exposure to certain chemicals such as benzene, radiation exposure, and smoking. These can damage DNA and increase cancer risk.
– Prior chemotherapy treatment or radiation therapy for other cancers like breast cancer. This DNA damage from chemo and radiation increases AML risk.
– Genetic syndromes like Down syndrome or Klinefelter syndrome.
– Blood disorders like myelodysplastic syndromes or myeloproliferative neoplasms.
– A family history of leukemia among first-degree relatives. Genetic factors play a role in AML risk.
– Getting older, as about 90% of AML patients are diagnosed after age 55. The risk increases with age.
Diagnosis of Acute Myeloid Leukemia (AML)
To Acute myeloid leukemia (AML) AML, doctors will conduct tests to look for signs and symptoms of leukemia:
– Complete blood count (CBC) to check for low blood cell counts.
– Bone marrow aspiration and biopsy, where a needle is used to extract a small amount of liquid and solid bone marrow for examination. This shows if the percentage of abnormal white blood cells is high.
– Cytogenetic analysis identifies any genetic changes in the chromosomes of bone marrow cells. Certain gene mutations are linked to poorer outcomes.
– Immunophenotyping uses antibody testing to determine what types of white and red blood cells are present in the bone marrow and blood.
– Molecular genetic tests can check for specific mutations associated with AML. Finding these mutations aids treatment decisions.
Stages of AML
There are no stages for AML like with solid tumors. Instead, doctors determine the prognosis and treatment options based on a combination of factors:
– The percentage of abnormal white blood cells (blasts) in the bone marrow. Higher percentages indicate a worse prognosis.
– Genetic mutations present that cause the leukemia. Gene mutations known to predict outcomes are a major factor in treatment plans.
– Age of the patient. Younger patients tend to have better prognoses and responses to treatment.
– Initial response to induction chemotherapy. Those who achieve remission after initial treatment have a better outlook than non-responders.
Treatment of Acute Myeloid Leukemia (AML)
The primary treatment for AML involves chemotherapy with the goal of inducing remission by lowering the number of abnormally functioning blast cells in the blood and restoring normal bone marrow function:
– Chemotherapy is usually given in intensive phases called induction therapy and consolidation therapy. The goal is to destroy leukemic cells and allow new healthy blood cells to regrow.
– Common drugs used are cytarabine, daunorubicin, idarubicin, fludarabine. Some new targeted therapies like midostaurin have been approved for certain mutations.
– Half of AML patients 65 and under will achieve a complete remission with chemotherapy. Older patients often need less intensive treatment plans.
– For those who obtain remission, additional chemotherapy may be given to further lower the risk of relapse. Sometimes a stem cell transplant is used for consolidation.
– New targeted therapies and immunotherapy approaches are improving outcomes by attacking specific molecular changes that fuel leukemia growth and progression. Future combinations may transform AML into a more manageable chronic disease.
– Supportive care involves blood transfusions, antibiotics for infection prevention, and managing complications like anemia and low blood pressure. This makes chemotherapy more tolerable.
Prognosis for Acute Myeloid Leukemia (AML)
The prognosis varies significantly depending on a range of factors:
– Overall survival rates are around 30% for all ages. But younger, healthier patients who achieve remission have 5-year survival rates approaching 60%.
– Those with specific gene mutations, extra chromosome changes, or a poor response to initial chemo typically have worse prognoses and higher relapse risks.
– Older adults over age 60 have average survival times of 5-10 months without treatment. But even low-intensity chemo or targeted therapy can provide benefits.
– Preventing and treating infections, minimizing treatment-related side effects, and managing other complications improves quality of life and outcomes.
– New research constantly provides insight into the underlying biology driving AML, which enables development of more targeted and effective therapies that can further increase cure rates over time.
In summary, Acute Myeloid Leukemia (AML) is a fast-growing form of leukemia that requires prompt treatment. While challenging, maintaining a hopeful outlook is important as advancing medical knowledge continues to improve survival rates through customized care approaches.
*Note:
1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it
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