1 What is Acute Myelogenous Leukemia (AML)?

Acute myelogenous leukemia (AML), or acute myeloblastic leukemia, is a rapidly-progressing blood cancer affecting myeloid cells in bone marrow.

Myeloid cells are the precursors of red blood cells, white blood cells and platelets. Immature cells produced by bone marrow are unable to resist attacks by infectious agents.

AML may also result in the production of abnormal red blood cells and platelets. These abnormal blood cells increase rapidly in number and soon crowd out the normal, healthy cells in blood. 

If left untreated, AML can be fatal. As the disease progression becomes rapid, abnormal blood cells may soon spread to other organs like the liver, spleen, brain and spinal cord.

The outcome of the treatment is positive if the patient responds well, particularly if the patient is less than 60 years of age and does not have a history of blood disorders.

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2 Symptoms

Some of the earliest symptoms of Acute myelogenous leukemia (AML) resembles that of a flu. It is important to differentiate these from those caused by blood cancer.

The most common symptoms include:

AML is also associated with anemia, leukopenia, thrombocytopenia, swollen lymph nodes, and enlarged liver and spleen.

3 Causes

Acute myelogenous leukemia (AML) is caused by damage to the DNA of bone marrow cells.

The affected cells produce abnormal blood cells. Cells produced by the damaged cells are immature and develop into cancer cells called myeloblasts. These myeloblasts are produced in large amounts and soon crowd out the normal healthy cells.

The actual cause of DNA damage in the marrow cells is not clear. Some of the factors that are identified as risk factors include:

  • High dose radiation – very high doses of radiation ie. chemotherapy
  • Exposure to industrial chemicals – chemicals like benzene may trigger DNA damage when exposed over a long term of period.
  • Tobacco – tobacco smoke for a long period exposes the person to harmful chemicals
  • Blood disorders - pre-existing blood disorders like myeloblastic syndrome increases the risk of this condition.
  • Genetic disorders – certain genetic disorders like Down syndrome and Bloom syndrome enhance the risk of AML

4 Making a Diagnosis

Common tests conducted to making a diagnosis of Acute myelogenous leukemia (AML) are:

  • Blood tests – a complete blood count reveals higher levels of white blood cells with low levels of red blood cells and platelets. Blood tests also help to identify the abnormal blood cells that indicate cancer.
  • Bone marrow aspiration and biopsy – a bone marrow aspiration is used to remove a fluid sample from the bone marrow. A biopsy is used to remove a small section of tissue from the marrow. Analysis of the samples help in diagnosing this blood cancer.
  • Other tests like flow cytometry, cytochemistry and karyotyping help in identifying specific genes and proteins that are characteristic of AML
  • Spinal tap – a spinal tap or lumbar puncture is used to take a sample of cerebrospinal fluid in order to check for cancer cells.
  • Imaging techniques – images of body parts helps to identify the cause of symptoms and to diagnose infections. Imaging methods like a CT scan or MRI are commonly used for this purpose.

Subtypes of AML are based on the characters determined by microscopic examination of the cells.

5 Treatment

Treatment of Acute myelogenous leukemia (AML) depends on the age of the patient, the type of AML, and the overall health of the patient.

The different treatment options available for AML include:

  • Chemotherapy – this method uses medications to destroy cancer cells and to prevent the growth of abnormal cells. The drug may be given intravenously, orally or in the form of an injection. The first phase of this is induction therapy in which the drug is given within 3-4 weeks of diagnosis. Induction therapy focuses on destroying cancer cells and resolving the symptoms. The second phase is remission consolidation or intensification therapy in which a combination of drugs is given to kill the remaining abnormal cells. In the third phase, remission maintenance therapy, treatment is continued to prevent recurrence of AML. A preventive treatment called central nervous system prophylaxis is given to prevent the cancer spreading to the brain and spinal cord.
  • Targeted therapy – with this method, specific genes or proteins that induce cancer are targeted. It prevents the growth and spread of cancer cells. More and more molecular targets are now being tested for the control of cancer.
  • Radiation therapy – a high energy X-ray helps to destroy cancer cells. The radiation is given over a period of time.
  • Bone marrow transplant – the affected bone marrow is replaced by highly specialized cells that may develop into healthy bone marrow.

6 Alternative and Homeopathic Remedies

There are several alternative and homeopathic remedies used for Acute Myelogenous Leukemia (AML).

Acupuncture, massage, aromatherapy, and relaxation techniques are used to alleviate the symptoms of AML.

Mangosteen herb, flavonoids, bilberry, curcumin, rosemary, and lyceum berry extracts are also being studied as beneficial supplements for the treatment of this cancer.

7 Lifestyle and Coping

Getting support from family and friends for appointments, treatments and programs helps to adapt your lifestyle in coping with with Acute myelogenous leukemia (AML).

Learning more about the disease helps to understand and cope better with the treatment.

Each of the treatment procedures are associated with many side effects.

The side effects may vary among individuals and it is important to inform the doctor regarding each one of them.

8 Risks and Complications

A weakened immune system is the most common complication of Acute myelogenous leukemia (AML).

This makes the person more susceptible to many infections, which in turn increases the chance of other complications.

9 Related Clinical Trials