Acute Myeloid Leukemia (AML)

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After completing a thorough lab analysis of your recent biopsy, a specialized doctor called a pathologist reported a diagnosis of acute myeloid leukemia (AML), which is a type of blood cancer. The disease most often affects adults over the age of 65.

About the Condition

Leuk Diag 12-21-09The soft inner tissue that fills the cavities of bones is called bone marrow. In adults, certain bones such as the skull, shoulder blades, ribs, pelvis and vertebrae (backbones) contain red bone marrow, which is the site of the body’s blood stem cells. These cells develop into blood-forming cells that then produce various components of the blood such as red and white blood cells and platelets. (Blood stem cells are not the same as embryonic stem cells.)

Acute myeloid leukemia is cancer that occurs when blood stem cells in the bone marrow do not proliferate, mature and expire in a normal manner. The extra cells that result can spread beyond the bone marrow to organs such as the spleen or liver, which can become enlarged.

The term acute refers to the fact that the disease forms in immature bone marrow cells and progresses quickly without treatment. Symptoms of AML may include fatigue, fever, night sweats, increased risk of infection, weight loss, excessive bruising or bleeding, bone or joint pain, and anemia (reduced red blood cell count). Some patients experience skin rashes, swollen gums and abdominal swelling.

There are multiple subtypes of the disease based on specific features of the cancer cells and their chromosomal structure (cytogenetics). Also an important distinction is made between AML cases that have an abrupt onset (de novo leukemia) and those that have a background of myelodysplasia, which are disorders in producing healthy mature blood cells. Your doctor can tell you more about your AML subtype.

Treatment Options

Although AML progresses rapidly, some subtypes respond well to treatment. Deciding on a treatment plan can be complex and depends upon a variety of factors, such as the disease subtype and your age, general health condition and personal preferences.

There are two phases of treatment for AML — induction therapy and consolidation therapy. Induction therapy focuses on bringing about (inducing) a remission, which is the elimination of visible signs of the disease. Consolidation therapy, also known as post-remission therapy, seeks to destroy any remaining cancer cells and prevent a relapse.

The following treatment possibilities are available:

Chemotherapy – The use of anti-cancer drugs, or chemotherapy, provides a way to kill leukemia cells systemically (throughout the body) via the bloodstream. Often a combination of several drugs is given, which varies based on the stage of cancer.

Other Drugs – Some patients who have the specific AML M3 subtype are treated with other drugs that may include all-trans retinoic acid or arsenic trioxide.

(Hematopoietic) Stem Cell Transplant – Stem cell transplant involves the transfer of specific blood-forming (hematopoietic) cells after high-dose chemotherapy (and at times added radiation therapy). Cancer cells in the body along with healthy blood-forming cells in the bone marrow are destroyed by the chemotherapy, which is given following the harvest of transplant cells from the bone marrow or blood of the patient (autologous transplant). This usual method has lower risks than allogeneic transplant, when cells come from a matched donor. The harvested cells are frozen and later thawed for infusion into the body to help the bone marrow regenerate.

Radiation Therapy – Radiation therapy is not generally used to treat AML, but it is employed in a few cases to reduce bone pain or treat cancer that has spread to the brain and spinal fluid or testicles. External beam radiation is generally used, in which a high energy X-ray machine directs radiation at the affected area(s).

You may also consider participating in clinical trials. These investigative studies help doctors learn about new treatments and better ways to use established treatments. Talk with your doctor about the possibility of taking part in a clinical trial in your area.

What You Can Do

You can choose to take an active role in your health and well-being. Learn as much as you can about your condition and have a list of questions ready each time you meet with your doctor. Join a cancer support group, and talk with your family, friends, clergyperson or counselor as you feel comfortable. Keep all of your doctor’s appointments and promptly report any new symptoms or treatment side effects that develop. Also be sure to eat well including fruits and vegetables, get plenty of sleep and stay as active as you can.

Additional Resources

American Cancer Society, 800.227.2345, www.cancer.org
The Leukemia & Lymphoma Society, 800.955.4572, www.leukemia-lymphoma.org

This patient resource sheet is provided to you as a service of CBLPath® and is intended for information purposes only. It may not fully describe all aspects of your diagnosis and is not meant to serve as medical advice or a substitute for professional medical care. Your physician can provide you with a thorough explanation of your diagnosis and appropriate treatment options, which may vary. Only you and your physician can determine your best treatment plan.

Updated 8.12