Acute Myeloid Leukemia (AML)

What is acute myeloid leukemia (AML)?

Acute myeloid leukemia (AML) is a type of cancer that affects the blood and bone marrow. The disease gets the word “acute” in its name due to its capacity to progress quickly. This quick progression can then result in it spreading to other parts of the body (metastasize) which is why prompt detection and treatment is important in this aggressive disease. 
 
AML specifically impacts cells called myeloid cells. Myeloid cells are a type of blood cell. Normally myeloid cells are formed in the bone marrow and can mature into red blood cells, white blood cells, or platelets. In AML, the bone marrow is functioning abnormally and the myeloid cells turn into myeloblasts. Myeloblasts are immature white blood cells (leukemia cells) that never fully develop and do not function the way they are supposed to. AML can also cause the myeloid cells to form irregular red blood cells or platelets that do not function normally. In AML, the bone marrow keeps producing these abnormal leukemia cells and they begin to out-number the healthy cells. 
 
AML can go by many other names such as acute non-lymphocytic leukemia, acute granulocytic leukemia, acute myelogenous leukemia, and acute myelocytic leukemia.
 
 
Subtypes of AML
There are many different subtypes of AML, and knowing the specific subtype you have can be very important in determining the prognosis. AML subtypes are derived from how much the cancer cells deviate from the normal cells and by how mature they are. The World Health Organization (WHO) classification system and the French-American-British (FAB) system are two common methods used to classify AML subtypes.
 
 
Risk factors
 
  • Older age (65 years or older is at highest risk)
  • Previous chemotherapy or radiation treatment
  • Smoking
  • Chemical exposure such as benzene
  • Radiation exposure
  • Genetic disorders such as:
  • Fanconi anemia
  • Ataxia-telangiectasia
  • Diamond-Blackfan anemia
  • Severe congenital neutropenia (aka Kostmann syndrome)
  • Schwachman-Diamond syndrome
  • Li-Fraumeni syndrome
  • Bloom syndrome 
  • Sex (AML is more common in males)
  • Having a close relative with AML
  • Blood disorders such as:
  • Polycythemia vera
  • Idiopathic myelofibrosis
  • Essential thrombocytopenia 
 
 
Diagnosis 
A complete medical history and physical exam will be obtained and your physician will want to know any signs and symptoms you have had and for how long. Some tests that may be obtained to diagnose AML include:
 
  • Complete blood count (CBC) and differential: The complete blood count looks at the number of red blood cells, white blood cells, and platelets. The differential count looks at the number of each type of white blood cell. In people with AML, the CBC will most likely show too little red blood cells and platelets and an abundance of immature white blood cells (myeloblasts). 
  • Peripheral blood smear: A drop of blood is looked at under a microscope to reveal any changes in the number/appearance of cells. Looking at the cells under a microscope can also help to determine the subtype of AML a person has. 
  • Bone marrow test: This test involves the aspiration of a sample of bone marrow that is then biopsied. The sample is taken from the hipbone using a needle but can sometimes be taken from the breast bone. The bone marrow cells will be looked at under a microscope to determine their types. With a diagnosis of AML, at least 20% of the bone marrow cells are myeloblasts. 
  • Lumbar puncture: This test involves removing a sample of cerebrospinal fluid (CSF) in order to detect the spread of cancerous cells. This test is indicated if the physician suspects the AML may have spread to the central nervous system (brain and spinal cord).
  • X-rays, computerized tomography (CT) scan, or ultrasound: These imaging techniques can be used to detect the spread of cancer to other parts of the body.
 
Other tests:
  • Cytochemistry 
  • Flow cytometry and immunohistochemistry 
  • Polymerase chain reaction (PCR)
  • Cytogenetic testing
  • Fluorescent in situ hybridization (FISH)
 
 
Treatment
AML treatment is decided based on a person’s age, health status, and the subtype of their disease. Possible treatments for AML include:
 
  • Chemotherapy
  • Stem cell transplants
  • Clinical trials
  • Targeted drug therapy
  • Radiation therapy
 
 
 
# ACUTE MYELOID LEUKEMIA (AML) BY THE NUMBERS #
  • AML is the most common type of acute leukemia in adults
  • The average age of diagnosis of AML is 67
  • The risk of being diagnosed with AML is less than 0.5%
  • The American Cancer Society estimated that in 2017 there will be:
  • Approximately 62,130 new cases of leukemia (all kinds) and 24,500 deaths from leukemia (all kinds)
  • Approximately 21,380 new cases of AML
  • Approximately 10,590 deaths from AML

 

about acute myeloid leukemia (AML)
 
 

Sources:

  • “Acute myelogenous leukemia (AML).” Mayo Clinic. Mayo Foundation for Medical Education and Research, 12 Sep. 2015. Web. 31 Jul. 2017.
  • “Adult Acute Myeloid Leukemia.” Cleveland Clinic, 10 Sep. 2009. Web. 31 Jul. 2017.
  • “What is Acute Myeloid Leukemia?” American Cancer Society, 22 Feb. 2016. Web. 31 Jul. 2017.  
  • “What Are the Risk Factors for Acute Myeloid Leukemia?” American Cancer Society, 22 Feb. 2016. Web. 31 Jul. 2017.
  • “How Is Acute Myeloid Leukemia Diagnosed?” American Cancer Society, 22 Feb. 2016. Web. 31 Jul. 2017. 
  • “Treating Acute Myeloid Leukemia.” American Cancer Society, 22 Feb. 2016. Web. 31 Jul. 2017.
  • “What Are the Key Statistics About Acute Myeloid Leukemia?” American Cancer Society, 5 Jan. 2017. Web. 31 Jul. 2017. 

 

Treatment for blood disorders can be lengthy, which is why it is a good idea to make sure you have a strong relationship with your hematologist from the beginning. Here are three tips for choosing a hematologist:
 
blood disorders - coping and choosing a hematologist

 

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