Acute myelogenous leukemia (AML)

Acute myelogenous leukemia (AML) is also known as acute myeloid leukemia, acute myeloblastic leukemia, acute nonlymphocytic leukemia, and acute granulocytic leukemia. It is the cancer of myeloid cells, a group of immature white blood cells (myeloblasts or leukemic blasts) that become one of three mature blood cells: red blood cell, white blood cell, or platelets. Chronic myelogenous leukemia is as disease in which patients have a group of too many mature white blood cells. Chronic myelogenous leukemia is also called as chronic myeloid leukemia. The rapid abnormal growth of these myeloid cells in the bone marrow interferes with the normal production of blood cells causing leukemia disease.

Signs and symptoms

The signs and symptoms of AML occur due to impaired production of normal blood cells.

  • Anemia
  • Fever
  • Dizziness
  • Loss of appetite
  • Shortness of breath
  • Delayed healing
  • Frequent and recurrent infections
  • Unusual bleeding
  • Easy bruising

The other associated symptoms include shortness of breath, fatigue, weakness, and tiredness.

Causes

There is no known cause of AML. Mutations in the DNA of the myeloid cells lead to leukemia, but the cause of the mutations is still unclear.

Coping and support

People requiring intensive chemotherapy may need to stay in the hospital for several weeks, and the treatment often lasts for 2 to 3 years. You may also need to cope with the other issues such as unwanted side effects of the therapy and the physical changes occurring due to the debilitating treatment.

To help you cope with the therapy, you need to learn about leukemia and feel comfortable in making treatment decisions. Each time you are going to see your doctor, make a clear communication and clarify all the suspicions regarding treatment.

Risk factors

Men, elderly people, smokers, individuals who are exposed to radiation and benzene are at high risk for leukemia. Individuals with certain blood disorders, such as, polycythemia vera (bone marrow disorder), myelodysplasia (bone marrow failure disorder), or thrombocytopenia (deficiency of blood platelets) are also at increased risk of AML. In rare cases, chemotherapy and radiotherapy may also cause leukemia.

Self-management

Good nutrition and a healthy lifestyle can make you feel better during and after cancer treatment. They play a significant role in keeping the body stronger and supporting the immune system.

Some alternative therapies such as meditation, relaxation exercises, acupuncture, and massage can help to improve symptoms. Notify your doctor before opting these alternate therapies.

Prognosis

In most cases, the treatment for AML is successful. The chances of recovery depend on age, subtype of AML, history of chemotherapy or any blood disorder, and spread of the disease.

The diagnosis of acute myeloid leukemia begins with a thorough review of medical history and a physical examination. Other tests include:

Blood tests - The WBC count increases whereas RBC and platelets decrease. Myeloblasts are immature cells and are not found in the circulating blood. Bone marrow biopsy  - With the help of a needle, your doctor takes a sample of tissue from bone marrow and sends to laboratory for examination. Cytogenetic analysis - the cells of blood or bone marrow are observed under a microscope to detect changes in chromosomes.

In some cases, your doctor may recommend lumbar puncture for examining the cells. If you are diagnosed with leukemia, your doctor refers to an oncologist or hematologist.

It is essential to determine AML subtype before initiating the treatment. AML subtype is determined by performing the tests to examine appearance and characteristics of the cells.

Acute myelogenous leukemia treatment begins immediately after the diagnosis, as the disease progresses rapidly.

Chemotherapy is the primary treatment option. Anti-cancer drugs such as cytarabine, hydroxyurea, and 6-thioguanine are used to treat AML. Chemotherapy has two phases, induction and postremission.

Induction therapy - To achieve complete remission by decreasing the number of leukemic cells and obtaining the normal blood cell count.
Postremission therapy  : To eliminate any residual undetectable disease and achieve cure

Radiation therapy can also be given to shrink the tumor. Bone marrow transplantation is performed to transplant bone-forming stem cells. Stem cells are taken from a donor or your bone marrow.