Acute Myelogenous Leukemia

 Overview

Acute myelogenous leukemia (AML) is also known as acute myeloid leukemia, acute myelocytic leukemia, acute granulocytic leukemia and acute non-lymphocytic leukemia.  AML starts in bone marrow cells that would normally develop into different types of blood cells.

Our patients with AML are treated at the Moores Leukemia and Lymphoma Unit. See the Leukemia and Lymphoma Unit for more information.

You can also review the tabs at top of this page for information on AML symptoms, risks, and treatment.

 Symptoms and Risks

Symptoms

  • Tiredness, lack of energy
  • Weight loss, lack of appetite
  • Shortness of breath during physical activity
  • Pale skin
  • Swollen gums
  • Slow healing of cuts and/or prolonged bleeding from minor cuts
  • Pinhead-size red spots under the skin
  • Mild fever
  • Black-and-blue marks with no clear cause
  • Aches in bones or knees, hips or shoulders

Risk Factors

The precise cause of AML is not yet known and although some risk factors have been identified, many AML patients do not have these risk factors.

  • Smoking
  • Some types of chemotherapy, such as mechlorethamine, procarbazine, chlorambucil, etoposide, teniposide and cyclophosphamide. Combining these drugs with radiation therapy further increases the risk.
  • Exposure to large amounts of benzene
  • Down syndrome and other uncommon genetic disorders such as Fanconi anemia , Bloom syndrome, ataxia-telangiectasia, and Shwachman-Diamond syndrome
  • Patients with certain blood disorders such as myeloproliferative disorders
  • Some patients with a myelodysplastic syndrome

 

 Treatment

Chemotherapy

Most AML treatment begins with intensive anti-cancer drug therapy, called chemotherapy, administered orally or injected.  A combination of two or three drugs is usually given. The first round of therapy is called induction therapy. Done in the hospital, it is used to kill as many AML cells as possible and get blood cell counts back to normal over time, which is considered to be remission.I f one week of therapy does not induce remission, the process may be repeated.

Because a small percentage of cancer cells may remain after this first round of therapy, the next treatment is called high-dose consolidation (post-remission) therapy. Also done in the hospital, this may include additional chemotherapy with or without a blood and marrow transplant.

Blood and Marrow Transplant (BMT)

The two primary types of BMT are autologous (using your own previously harvested cells) and allogeneic (using cells from a donor).  Both are preceded by high-dose chemotherapy and/or radiation, which destroy not only the cancerous cells in your body, but healthy cells as well. You will be in the hospital during this time, to ensure that you are not exposed to possible infection. Then, during the transplant procedure, you’ll receive healthy cells which make their way to your bone marrow and start producing new blood cells.

Radiation Therapy

Radiation, the use of high-energy x-rays or other types of radiation to kill cancer cells or prevent them from growing, is sometimes used to treat  AML that has spread to the brain and spinal fluid or to the testicles. Radiation to the whole body is often an important part of treatment before a bone marrow or peripheral blood stem cell transplant. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The method chosen depends on the type of the cancer being treated.

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