Acute Myeloid Leukemia is a cancer of blood and bone marrow (the soft inner tissue of certain bones). AML is fast-growing cancer that affects the group of white blood cells called myeloid cells, which normally develop into platelets, red blood cells, or white blood cells.
With AML, the bone marrow cells grow abnormally and build up in the body. If not treated or managed on time, cancer can reach the blood, lymph nodes, liver, spleen, etc.
AML is also known as acute myeloblastic leukaemia, acute myeloid leukaemia, acute nonlymphocytic leukaemia, and acute granulocytic leukaemia. Specialists that diagnose and treat AML are haematologist-oncologists.
Signs and Symptoms of Acute Myeloid Leukemia
Signs and Symptoms of AML include:
Unusual frequent infections
Unusual bleeding or bruising
Tiny red spots on the skin
Causes of Acute Myeloid Leukemia
Acute Myeloid Leukemia is caused due to mutations in the DNA of bone marrow cells. These alterations disturb the normal cell activity and result in the abnormal growth and multiplication of cells.
These mutations affect blood cell production and make bone marrow produce immature cells that develop into leukaemia WBC called myeloblasts. As a result, these cells perform abnormally and crowd over healthy cells.
Types of Acute Myeloid Leukemia
AML with minimal maturation
AML with maturation
Acute promyelocytic leukaemia (APL)
Acute myelomonocytic leukaemia
Acute myelomonocytic leukaemia with eosinophilia
Acute monocytic leukaemia
Acute erythroid leukaemia
Acute megakaryoblastic leukaemia
Risk Factors of Acute Myeloid Leukemia
It is not clear what causes these mutations in the DNA of blood cells. However, there are certain risk factors that include:
Increasing age: AML is most common in adults of age 65 and above.
Past cancer treatment: Chemotherapy and radiation therapy may increase the risk of AML.
Exposure to radiation and certain chemicals
Other blood disorders like myelofibrosis, myelodysplasia, polycythemia vera or thrombocythemia, etc.
Smoking, as cigarettes contain chemicals like benzene.
Genetic disorders like down syndrome are related to AML.
Diagnosis and Tests For Acute Myeloid Leukemia
The doctors diagnose acute myeloid leukaemia after enquiring the patient's medical history, symptoms, and physical examination followed by some tests and diagnostic procedures such as
1. Blood tests include
Complete blood count to check the levels of white blood cells, red blood cells, and platelets. With AML, one has more WBC and fewer RBC and platelets.
Peripheral blood smear to check the size, number, and shape of WBC under a microscope.
2. Bone Marrow Test: Once a blood test indicates AML, a bone marrow test is used to confirm the diagnosis. The doctor takes a biopsy of tissue and looks for cancer cells under a microscope.
3. Lumbar puncture (spinal tap): A doctor uses a needle to collect cerebrospinal fluid (CSF): a fluid that surrounds the brain and spinal cord. CSF is examined under a microscope to look for the presence of leukaemia cells.
4. Other tests: A doctor can suggest various other tests like
Fluorescent in situ hybridization (FISH)
Polymerase chain reaction (PCR), etc.
Based on your diagnostic test results and AML subtype, the doctor will determine the prognosis and decide on suitable treatment options. Unlike other cancers, AML doesn’t have any stages.
The treatment is decided on various factors such as
Results of diagnostic tests
Possible Treatment of Acute Myeloid Leukemia
Treatment of acute myeloid leukaemia depends upon the age, overall health, preferences, and the subtype of AML.
The treatment of AML falls into two phases:
1. Phase 1 - Remission induction therapy: High doses of chemotherapy and targeted therapy drugs are given to kill leukaemia blast cells.
2. Phase 2 - Consolidation therapy: Also known as post-remission therapy, uses more treatments to kill the remaining cancer cells.
Following are the therapies used in the above phases:
Chemotherapy: To use specific chemo drugs to destroy cancer cells.
Targeted Therapy: To block specific abnormalities in the cancer cells.
Bone marrow transplant: A procedure to replace unhealthy bone marrow with healthy stem cells.