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Acute myeloid leukaemia (AML) Explained

What is acute myeloid leukaemia?

A cancer of the blood and the bone marrow is known as acute myeloid leukaemia (AML). Cancer’s rapid development is referred here by the word “acute”. Myeloid cells are a kind of cells present in the bone marrow, which matures into various cells such as white blood cells, red blood cells and the platelets. Leukaemia means uncontrolled growth of these cells.

Acute myeloid leukaemia is also referred to as acute myeloblastic leukaemia, acute myelogenous leukaemia, acute nonlymphocytic leukaemia and acute granulocytic leukaemia.

Acute myeloid leukaemia begins in the bone marrow and in the majority of the instances, AML rapidly moves into the blood. Sometimes, it can spread to other parts of the body also.

Acute myeloid leukaemia is usually a disease seen in the older individuals and it is unusual before 45 years of age. Incidence is more in males than in females.

Acute myeloid leukaemia (AML) Explained

Causes and risk factors

Causes

Acute myeloid leukaemia results due to mutations in the DNA of cells present in the bone marrow. These mutations lead to the production of the wrong kind of cells in the bone marrow. Such cells are unable to function in a proper way and surround the normal cells that are healthy.

In a majority of cases, the reason for the mutations of the DNA is not known precisely. However, chemical exposures, radiation, certain drugs used in chemotherapy are potential causes for AML.

Risk Factors

The known risk factors for AML include:

  • Genetic syndromes like Down syndrome
  • Increasing age
  • Gender: Males are more prone, compared to females; the exact cause is not known
  • Family history
  • Certain blood disorders: People with thrombocythemia, polycythemia vera or myelodysplasia are at higher risk of AML development.
  • Smoking
  • Exposure to chemicals
  • Chemotherapy drugs
  • Radiation

There are instances where many individuals with known risk factors never developed this disease and also people with this cancer had no known risk factors.

Symptoms and signs

The usual symptoms and signs of early onset of acute myeloid leukaemia can be similar to common flu and other diseases. Depending on the type of the affected blood cells, the symptoms and signs can vary. Some of these symptoms and signs may be:

  • Pain in bones
  • Fever
  • Fatigue
  • Pale skin
  • Shortness of breath
  • Repeated illnesses
  • Atypical bleeding (recurrent gum and nose bleeding)

Diagnosis

On suspecting AML, your doctor may refer you to an oncologist – a doctor specialising in cancer or to a haematologist – a doctor who is a specialist of tissues forming blood.

Physicians on noticing symptoms and signs of acute myeloid leukaemia may recommend:

Blood Tests:

Majority of individuals with acute myeloid leukaemia have immature (blast) cells in their bone marrow but not in their blood. Also, they have numerous white blood cells and less of platelets and red blood cells.

Acute myeloid leukaemia (AML) Explained

Bone marrow test.

Bone marrow biopsy is done to take a sample of the bone marrow using a needle and analysed in a lab.

Occasionally, some fluid sample from the spinal cord might be necessary to detect leukaemic) cells.

Treatment and prevention

If AML is confirmed, a further staging will be done via specialised lab tests for determining the suitable treatment. The other factors determining treatment include the general health and the age of the individual.

Chemotherapy:

It involves the use of chemical substances to destroy the cancerous cells in the body. Usually, individuals on chemotherapy require hospitalisation as most of the healthy cells also get destroyed.

Stem cell treatment:

Transplantation of the bone marrow also called stem cell transplantation, aims at the replacement of the unhealthy cells in the bone marrow with healthier stem cells.

Before infusion of donor cells into the bone marrow, one may be exposed to high levels of radiotherapy or chemotherapy to destroy the bone marrow that causes leukaemia.

The general phases of treatment of both the chemotherapy or radiotherapy include:

Remission induction therapy

It aims at the destruction of leukaemia causing cells in the bone marrow and the blood. However, this therapy will not completely kill the entire leukaemia cells requiring additional treatment for prevention of relapse.

Post-remission therapy

It is also known as maintenance therapy or consolidation therapy; this therapy is done to kill the lingering leukaemia cells. It’s considered crucial to decrease the risk of relapse.

Prevention

The majority of individuals with AML do not have avoidable risk factors. There are no precise causes of AML. Hence, there are no preventive measures against many of the incidences of leukaemia.

Avoiding exposure to certain chemicals and quitting smoking can reduce an individual’s chances of leukaemia.

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Next steps

If you notice any symptoms of acute myeloid leukaemia, visit your family physician or a cancer specialist or haematologist.

Note down all the medications you are currently taking and list down the questions you have regarding the disease, type of tests required to diagnose and any other related issues.

Red Flags

Acute myeloid leukaemia is a group of illness and in a majority of instances, it can progress very rapidly so it is vital to initiate treatment as early as possible.

Consult a top Oncologist

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References

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  • Leukemia–Acute Myeloid (Myelogenous). American Cancer Society. Accessed on 25 Jan. 16. http://www.cancer.org/acs/groups/cid/documents/webcontent/003110-pdf.pdf
  • Adult acute myeloid leukemia treatment (PDQ). National Cancer Institute. Accessed on 25 Jan. 16. http://www.cancer.gov/types/leukemia/patient/adult-aml-treatment-pdq.
  • Leukemia — acute myeloid — AML. Cancer.Net. Accessed on 25 Jan. 16.  http://www.cancer.net/cancer-types/leukemia-acute-myeloid-aml/view-all
  • Acute myeloid leukemia (AML). Leukemia & Lymphoma Society. Accessed on 25 Jan. 16.  https://www.lls.org/leukemia/acute-myeloid-leukemia

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