Acute Myeloid Leukemia

What is leukemia?

Leukemia is a term for cancers of the blood cells. Leukemia starts in blood-forming tissues such as the bone marrow. Your bone marrow makes the cells which will develop into white blood cells, red blood cells, and platelets. Each type of cell has a different job:

• White blood cells help your body fight infection
• Red blood cells deliver oxygen from your lungs to your tissues and organs
• Platelets help form clots to stop bleeding

When you have leukemia, your bone marrow makes large numbers of abnormal cells. This problem most often happens with white blood cells. These abnormal cells build up in your bone marrow and blood. They crowd out the healthy blood cells and make it hard for your cells and blood to do their work.

What is acute myeloid leukemia (AML)?

Acute myeloid leukemia (AML) is a type of acute leukemia. "Acute" means that the leukemia usually gets worse quickly if it's not treated. In AML, the bone marrow makes abnormal myeloblasts (a type of white blood cell), red blood cells, or platelets. When the abnormal cells crowd out the healthy cells, it can lead to infection, anemia, and easy bleeding. The abnormal cells can also spread outside the blood to other parts of the body.

There are several different subtypes of AML. The subtypes are based on how developed the cancer cells are when you get your diagnosis and how different they are from normal cells.

What causes acute myeloid leukemia (AML)?

AML happens when there are changes in the genetic material (DNA) in bone marrow cells. The cause of these genetic changes is unknown. However, there are certain factors that raise your risk of AML.

Who is at risk for acute myeloid leukemia (AML)?

The factors that raise your risk of AML include:

• Being male
• Smoking, especially after age 60
• Having had chemotherapy or radiation therapy
• Treatment for acute lymphoblastic leukemia (ALL) as a child
• Exposure to the chemical benzene
• A history of another blood disorder such as myelodysplastic syndrome

What are the symptoms of acute myeloid leukemia (AML)?

The signs and symptoms of AML include:

• Fever
• Shortness of breath
• Easy bruising or bleeding
• Petechiae, which are tiny red dots under the skin. They are caused by bleeding.
• Weakness or feeling tired
• Weight loss or loss of appetite
• Bone or joint pain, if the abnormal cells build up near or inside the bones

How is acute myeloid leukemia (AML) diagnosed?

Your health care provider may use many tools to diagnose AML and figure out which subtype you have:

• A physical exam
• A medical history
• Blood tests, such as a complete blood count (CBC) and blood smear
• Bone marrow tests. There are two main types - bone marrow aspiration and bone marrow biopsy. Both tests involve removing a sample of bone marrow and bone. The samples are sent to a lab for testing.
• Genetic tests to look for gene and chromosome changes

If you are diagnosed with AML, you may have additional tests to see whether the cancer has spread. These include imaging tests and a lumbar puncture, which is a procedure to collect and test cerebrospinal fluid (CSF).

What are the treatments for acute myeloid leukemia (AML)?

Treatments for AML include:

• Chemotherapy
• Radiation therapy
• Chemotherapy with stem cell transplant
• Other anticancer medicines

Which treatment you get often depends on which subtype of AML you have. Treatment is usually done in two phases:

• The goal of the first phase is to kill the leukemia cells in the blood and bone marrow. This puts the leukemia into remission. Remission means that the signs and symptoms of cancer are reduced or have disappeared.
• The second phase is known as post-remission therapy. Its goal is to prevent a relapse (return) of the cancer. It involves killing any remaining leukemia cells that may not be active but could begin to regrow.

NIH: National Cancer Institute