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Acute myeloid leukemia (AML) is a cancer that occurs in your blood and in the marrow of your bones. Marrow is a sponge-like material inside your bones that produces blood cells. AML specifically affects the white blood cells of your body, causing them to form abnormally. The number of abnormal cells grows rapidly.
There are about 20,830 new cases of AML every year in the United States.
In its early stages, the symptoms of AML may resemble the flu and you may have a fever and fatigue. Other symptoms can include:
AML is caused by abnormalities in the DNA that controls the development of cells in your bone marrow. If you have AML, your bone marrow creates countless white blood cells that are immature. These abnormal cells eventually become leukemic white blood cells called myeloblasts. These abnormal cells build up and replace healthy cells. This causes your bone marrow to stop functioning properly, making your body more susceptible to infections.
It’s not clear exactly what causes the DNA mutation. Some doctors believe it may be related to exposure to certain chemicals, radiation, and even drugs used for chemotherapy.
Your risk of developing AML increases with age. The average age for a person with AML is about 67. AML is also more common in men than women.
Cigarette smoking is thought to increase your risk of developing AML. If you work in an industry where you may have been exposed to chemicals such as benzene, you’re also at higher risk. Your risk also goes up if you have a blood disorder such as myelodysplasia or a genetic disorder such as Down syndrome.
These risk factors don’t mean you’ll necessarily develop AML. At the same time, it’s possible for you to develop AML without having any of these risk factors.
Your doctor will perform a physical exam and check for swelling of your liver, lymph nodes, and spleen. Your doctor may also order blood tests to check for anemia and to determine your white blood cell levels.
While a blood test may help your doctor determine whether there’s a problem, a bone marrow test or biopsy is needed to diagnose AML definitively. A sample of bone marrow is taken by inserting a long needle into your hip bone. Although, sometimes the breastbone is the site of biopsy. The sample is sent to a lab for testing.
Your doctor may also do a spinal tap, or lumbar puncture, which involves withdrawing fluid from your spine with a small needle. The fluid is checked for the presence of leukemia cells.
Treatment for AML involves two phases:
Remission induction therapy uses chemotherapy to kill the existing leukemia cells in your body. Most people stay in the hospital during treatment because chemotherapy also kills healthy cells, raising your risk for infection and abnormal bleeding. In a rare form of AML called promyelocytic leukemia, anti-cancer drugs such as arsenic trioxide or all-trans retinoic acid may be used to target specific mutations in leukemia cells. These drugs kill the leukemia cells and stop the unhealthy cells from dividing.
Consolidation therapy, which is also known as post-remission therapy, is crucial for keeping AML in remission and preventing a relapse. The goal of consolidation therapy is to destroy any remaining leukemia cells. You may require a stem cell transplant for consolidation therapy. Stem cells are often used to help your body generate new and healthy bone marrow cells. The stem cells may come from a donor. If you’ve previously had leukemia that has gone into remission, your doctor may have removed and stored some of your own stem cells for a future transplant, known as an autologous stem cell transplant.
Getting stem cells from a donor has more risks than getting a transplant made up of your own stem cells. A transplant of your own stem cells, however, involves a higher risk for relapse because some old leukemia cells may be present in the sample retrieved from your body.
With early-phase detection and prompt treatment, remission is highly likely in most people. Once all signs and symptoms of AML have disappeared, you’re considered to be in remission. If you’re in remission for more than five years, you’re considered cured of AML.
If you find that you have symptoms of AML, schedule an appointment with your doctor to discuss them. You should also seek immediate medical attention if you have any signs of infection or a persistent fever.
If you work around hazardous chemicals or radiation, make sure to wear any and all available protective gear to limit your exposure.
Written by: Carmella Wint and Winnie Yu
Medically reviewed on: Jan 26, 2016: Steve Kim, MD
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