Acute myelogenous leukemia (AML): Causes-Symptoms-Diagnosis-Treatment

What Is Acute Myelogenous leukemia?

Acute myelogenous leukemia (AML) is a cancer of the blood and bone marrow of the spongy tissue inner bones where blood cells are made.

The word "acute" in acute myelogenous leukemia denotes the disease's rapid development. It's called myelogenous leukemia as it influences a group of white blood cells called the myeloid cells, which typically become the numerous varieties of mature blood cells, inclusive of purple blood cells, white blood cells and platelets.

Acute myelogenous leukemia is also known as acute myeloid leukemia, acute myeloblastic leukemia, acute granulocytic leukemia and acute nonlymphocytic 

leukemia.

Medical term

Acute myelogenous leukemia (AML) is a type of cancer of the blood and bone marrow. It is one of the most common forms of leukemia, accounting for around 30% of all adult cases. AML is an aggressive form of cancer, with a fast-growing rate, and often requires chemotherapy or a bone marrow transplant in order to be treated. The primary symptom of AML includes anemia, fatigue, increased risk of infection, and easy bruising or bleeding.Acute myelogenous leukemia (AML) is a type of cancer of the blood and bone marrow. It is one of the most common forms of leukemia, accounting for around 30% of all adult cases. AML is an aggressive form of cancer, with a fast-growing rate, and often requires chemotherapy or a bone marrow transplant in order to be treated. The primary symptom of AML includes anemia, fatigue, increased risk of infection, and easy bruising or bleeding.

Here are some key features of AML:

• Bone Marrow and Blood Cells:

• AML primarily affects the myeloid cells in the bone marrow, which are responsible for producing red blood cells, white blood cells, and platelets.

• The leukemia cells in AML are immature and do not function like normal blood cells.

• Rapid Progression:

• AML is an aggressive disease that progresses rapidly. The abnormal cells proliferate quickly, crowding out the normal cells in the bone marrow.

Types of leukemia

There are four main types of leukemia, which are determined by the type of white blood cell that is affected and how quickly the leukemia develops. The four main types of leukemia are:  acute lymphocytic leukemia (ALL), chronic lymphocytic leukemia (CLL), acute myeloid leukemia (AML), and chronic myeloid leukemia (CML).

The primary kinds of leukemia are:

• Acute lymphocytic leukemia (ALL). This is the maximum not unusual type of leukemia in young kids. ALL can also arise in adults.

• Acute myelogenous leukemia (AML). AML is a not unusual form of leukemia. It occurs in children and adults. AML is the most common type of acute leukemia in adults.

• Hairy cell leukemia (HCL). Hairy cell leukemia (HCL) is a rare, chronic leukemia characterized by the presence of atypical circulating B lymphocytes, called hairy cells, in the peripheral blood.

• Chronic myelogenous leukemia (CML). This type of leukemia in particular impacts adults. An individual with CML may have few or no signs for months or years earlier than getting into a segment wherein the leukemia cells develop greater quickly.

• Other kinds. Other, rarer kinds of leukemia exist, including hairy cell leukemia, myelodysplastic syndromes and myeloproliferative problems.

Acute myelogenous leukemia rash

Patients affected with acute myelogenous leukemia (AML) are often diagnosed at later stages of the disease and thus have a poorer prognosis Early detection is critical in order to increase chances of survival as well as management of symptoms and side effects from cancer treatments.

Acute Myelogenous Leukemia (AML) is a type of cancer in which too many abnormal white blood cells are produced in the bone marrow The immature white blood cells accumulate destroying and stealing the production space of normal hematopoietic stem cells leading to a shortage of healthy red and white blood cells platelets and other important proteins that the body needs to function.

Symptoms Acute myelogenous leukemia (AML)

Acute myelogenous leukemia (AML) can be difficult to diagnose Early signs and symptoms may mimic those of the flu or other common diseases

Signs and symptoms of acute myelogenous leukemia can include:

• Fever

• Bone pain

• Lethargy and fatigue

• Shortness of breath

• Pale skin

• Frequent infections

• Easy bruising

Bleeding that is not typical such as frequent nosebleeds and bleeding from the gums can be a sign of anemia

When to see a doctor

If you develop any symptoms that are unusual or that seem worrisome make an appointment with a doctor

Causes Acute Acute myelogenous leukemia (AML)

Acute myelogenous leukemia occurs when a bone marrow cell mutates The mutated cell has changes in the genetic material or DNA which tells it what to do Normally DNA tells the cells to grow at a set rate and to die at a set time In acute myelogenous leukemia this process is interrupted These mutations are also seen in other types of cancer that involve blood-forming tissues (lymphomas) mutations tell the bone marrow cells to continue growing and dividing

When the bone marrow produces immature white blood cells called myeloblasts white blood cell production becomes out of control The marrow produces immature cells that develop into leukemia white blood cells called myeloblasts These abnormal cells are unable to function properly and they can build up and crowd out healthy cells

It is not clear what causes the DNA mutations that lead to leukemia but doctors have identified factors that increase the risk

Risk factors Acute myelogenous leukemia (AML)

Factors that may increase your risk of acute myelogenous leukemia (AML) include:

• Increasing age.The risk of acute myelogenous leukemia increases with age Acute myelogenous leukemia is most common in adults age 65 and older

• Your sex. Men are more likely to develop acute myelogenous leukemia than are women.

• Previous cancer treatment.People who have had certain types of cancer treatment may be at greater risk for developing AML or ALL

• Exposure to radiation.People who are exposed to very high levels of radiation such as survivors of a nuclear reactor accident have an increased risk of developing AML (acute myeloid leukemia)

• Dangerous chemical exposure.Benzene is a chemical that has been linked to higher risk of AML

• Smoking.Cigarette smoke contains benzoic acid and other chemicals that cause cancer

• Other blood disorders.People who have had another blood disorder such as myelodysplasia myelofibrosis polycythemia vera or thrombocythemia are at greater risk of developing AML

• Genetic disorders.Certain genetic disorders such as Down syndrome are associated with an increased risk of AML

• Many people with AML have no known risk factors and many people who have risk factors never develop the cancer

Diagnosis Acute myelogenous leukemia (AML)

If you have signs or symptoms of acute myelogenous leukemia your doctor may recommend that you undergo a number of diagnostic tests This process involves testing the blood and bone marrow to determine the presence of cancer cells In some cases this is done through an examination where samples are drawn from the patient's blood and analyzed in a laboratory

• Blood tests. Most people with acute myelogenous leukemia have too many white blood cells compared to the number of red blood cells and platelets But sometimes there is a shortage of white blood cells; this can be because the level of white blood cells is too low In these cases immature blasts — immature cells normally found in bone marrow but not circulating in the bloodstream — can be present Leukemia can be diagnosed by the blood

• Bone marrow test.Blood tests can suggest a diagnosis of leukemia but bone marrow tests are usually needed to confirm the diagnosis

• Lumbar puncture (spinal tap).In some situations it may be necessary to remove some of the fluid around the spinal cord to check for leukemia cells Your doctor can collect this fluid by inserting a small needle into the spinal canal in your lower back

• Cell culture The laboratory tests the ability of cancer cells to grow in a petri dish That helps them predict how well these cells will respond to different treatments such as drugs or surgeryIn a laboratory doctors test your leukemia cells to better understand which gene mutations are present This can help determine your prognosis and guide your treatment

If your doctor suspects leukemia you may be referred to a specialist in blood cancer (hematologist or oncologist)

What is bone marrow?

Bone marrow is the soft, spongy tissue located in the center of all bones. It is a small space where different kinds of blood cells are created and where vital resources are supplied to help these cells grow. Blood cells keep our body healthy and running smoothly. There are many different types of blood cells that are produced in the bone marrow. These include: red blood cells, white blood cells, and platelets.

• Red blood cells carry oxygen and other materials to all parts of the body.

• White blood cells are responsible for fighting infection.

• Platelets are important because they help the blood to clot.

Your body produces billions of new blood cells each day in your bone marrow. This keeps you constantly supplied with fresh, healthy cells.

Determining your AML subtype

If your doctor determines that you have AML you may need further tests to determine the extent of the cancer and classify it into a more specific AML subtype

Your AML subtype is based on how your cells appear when examined under a microscope and may be confirmed by special laboratory testing

Doctors are studying how different types of cancer treatment affect people with different AML subtypes

Determining your prognosis

When doctors determine the type of cancer they use some information about your AML and other kinds of cancer to make their decision about what treatment you will receive Other types of cancer have numerical stages that indicate your prognosis and whether your cancer has spread; however there are no stages for acute myelogenous leukemia

The seriousness of your condition is determined by the following:

• AML subtype

• Your age

• Your overall health

• Results from other tests and procedures can be used to determine the effectiveness of a drug

Treatment Acute myelogenous leukemia (AML)

Treatment for acute myelogenous leukemia depends on several factors including: the subtype of the disease your age your overall health and your preferences

In general treatment will be divided into two phases:

• Remission induction therapy.The purpose of the first phase of treatment is to get rid of the leukemia cells in your blood and bone marrow If remission induction does not completely wipe out all the leukemia cells you will need further treatment to prevent it from coming back

• Consolidation therapy.Also called post-remission therapy or maintenance therapy this phase of treatment is aimed at destroying the remaining leukemia cells It's considered crucial to decreasing the risk of relapse

Therapies used in these phases include:

• Chemotherapy.Chemotherapy is the major form of remission induction therapy though it can also be used for consolidation therapy Chemotherapy uses chemicals to kill cancer cells in your body
  People with AML typically remain in the hospital during chemotherapy treatments because the drugs destroy many normal blood cells while killing leukemia cells If there is no response to one round of chemotherapy a second round can be used

• Targeted therapy. Treatments for leukemia focus on specific abnormalities that are present within cancer cells By blocking these abnormalities targeted drug treatments can cause cancer cells to die Your leukemia cells will be tested to see if targeted therapy may be helpful for you Chemotherapy is used in conjunction with other cancer treatments for the induction of therapy and consolidation of therapy

• Bone marrow transplant.A bone marrow transplant (also called a stem cell transplant) may be used for consolidation therapy Bone marrow transplants help reestablish healthy stem cells by replacing unhealthy bone marrow with leukemia-free stem cells that will regenerate healthy bone marrow
  Before a bone marrow transplant you receive very high doses of chemo or radiation therapy to destroy the leukemia-producing bone marrow Then you receive infusions of stem cells from a compatible donor (allogeneic transplant)

• Clinical trials.Some patients with leukemia choose to enroll in clinical trials to try experimental treatments or new combinations of known therapies

Alternative medicine

No proven therapies are available to treat acute myelogenous leukemia Some complementary and alternative treatments may relieve the symptoms you experience such as fatigue or nausea due to cancer or cancer treatment

Alternate treatments that may help relieve symptoms include:

• Acupuncture

• Exercise

• Massage

• Meditation

• Relaxation activities like yoga and tai chi help the body to release tension

Coping and support

Acute myelogenous leukemia is an aggressive form of cancer that requires quick decisions That leaves people with new diagnoses facing important decisions about a disease they may not yet understand Here are some tips:

• Learn enough about your condition and its treatment to make decisions about your care The term leukemia can be confusing because it refers to a group of cancers that aren't all that similar except for the fact they affect the bone marrow and blood You can waste a lot of time researching information that doesn't apply to your kind of leukemia To avoid that ask your doctor or nurse practitioner before you do anything else A doctor should write down as much information as possible then narrow your search accordingly
  Before each appointment write down questions for your doctor Search the internet and look in libraries for information on cancer and blood disorders

• Lean on family and friends.It can be difficult to approach a diagnosis You might receive a range of reactions when you share the news but it can be helpful to talk about your diagnosis and there’s also likely to be an outpouring of practical help that often results

• Take care of yourself.It is easy to get caught up in the test treatments and procedures of therapy But it is important to take care of yourself not just the cancer Try to make time for yoga cooking or other favorite diversions

Preparing for your appointment

If your doctor thinks you may have leukemia he or she will likely refer you to a specialist who specializes in blood cell diseases (hematologist) If your doctor suspects that you may have cancer of the blood it’s likely that he or she will actually ask to see a specialist

It’s best to be prepared for your appointment because doctors often spend only a few minutes with patients and a lot of that time is spent getting the history It’s important to know what to expect from your doctor before you go in Here are some things to consider:

• Psychological Rehabilitation for cancer

What you can do

• If you have any pre-appointment restrictions such as dietary restrictions allergies or health issues that might preclude you from taking part in a study please let the nurse know before your appointmentMake sure to ask the Doctor if there is anything you should do in advance such as restricting your diet

• Write down any symptoms you are experiencingWe ask that you consider all of your health issues when scheduling your examination

• Write down key personal information,major stresses or recent life changes (could be physical emotional social or financial)

• Make a list of all medications,Supplementation is needed to get the benefits of vitamins

• Consider inviting a family member or friend alongSometimes it can be difficult to remember all the information provided during an appointment Someone who accompanies you may remember something that you missed or forgot

• Write down questions to ask your doctor.

Your time with your doctor is limited so here's a list of questions to ask that might help you make the most of your time together List the questions in order from most important to least important so that you can prioritize them if necessary For acute myelogenous leukemia some basic questions to ask include:

• What is likely causing my symptoms or condition?

• What other things could be causing my symptoms or condition?

• What kinds of tests do I need?

• What is the best course of action?

• What are the alternative approaches that you are suggesting?

• I have these other health conditions. How can I best manage them together?

• Are there any restrictions that I need to follow?

• Should I seek a second opinion? What will that cost and will my insurance cover it?

• Is there a generic alternative to the medicine you're prescribing?

• Are there brochures or other printed material that I can take with me? What websites do you recommend?

• What will determine whether I should make a follow-up visit?

You shouldn't hesitate to ask other questions during your doctor's appointment

What to expect from your doctor

Your doctor is likely to ask you a number of questions This can allow time later to cover other points you want to address The doctor may ask:

• When did you first begin experiencing symptoms?

• Has the problem been continuous or occasional?

• How severe are your symptoms?

• You can ask your doctor about anything that improves your symptoms

• What are your symptoms?

What you can do in the meantime

It is best to avoid activities that worsen symptoms For example it would be wise to rest if you feel fatigue.

General summary

It's important for individuals experiencing symptoms or at risk for AML to seek medical attention promptly for proper diagnosis and treatment. The management of AML requires a multidisciplinary approach involving oncologists, hematologists, and other healthcare professionals.