AML Leukemia

Overview

Acute myelogenous leukemia (AML), a type of blood cancer that affects immature blood cells, comes on suddenly and causes easy bruising, fatigue and unusual bleeding. AML arises from a new (not inherited) DNA mutation in an immature blood cell that multiplies itself. Treatment involves inducing a remission of the cancer, followed by wiping out all remaining cancer cells. Most people with AML have a good prognosis and can reasonably expect a full recovery.

Description

In a person suffering from AML, cancer occurs in an immature blood stem cell and the bone marrow where it resides. The affected stem cell, called a myeloid cell, normally would divide into daughter cells that would in turn develop into red blood cells, white blood cells and platelets (clotting factors). Instead, this cancerous cell makes millions of copies of itself, and the copies have an unusually long life in the bloodstream. Because the immature and cancerous cells cannot perform the normal functions of mature, differentiated blood cells, various symptoms occur.

Symptoms

AML, as the name implies, comes on suddenly. Patients usually notice symptoms and receive their diagnosis within a few days to a few weeks. Symptoms can vary, depending on the type of blood cells most affected, but usually include fever and weight loss, fatigue, paleness, easy bruising and unusual bleeding, often from the nose or gums. Some of the early symptoms feel like the flu, but the bruising and bleeding indicate leukemia rather than a virus.

Risk Factors

According to the Mayo Clinic, AML occurs most commonly in people over 60, and it affects more men than women. The causative DNA mutation can result from factors like smoking, exposure to radiation or exposure to certain chemicals. People who have survived other cancers or who have another blood disease have a greater risk of developing AML.

Treatment

If you have symptoms of AML, see your doctor quickly because AML is an aggressive form of cancer that requires immediate treatment. The first phase of treatment, called induction, aims to induce remission by killing the bulk of the cancerous cells in blood and bone marrow. In the second phase, called consolidation therapy, the goal is to wipe out every last cancer cell to prevent a recurrence. Doctors might use the same form of therapy in both phases, though with a more intense regimen during consolidation, or they might recommend two or more different forms of therapy. Often used for induction, chemotherapy also can be used for consolidation. Other treatment options include anti-cancer drugs, immunotherapy or bone marrow stem cell transplant.

Prognosis

According to the Merck Manual, up to 85 percent of patients with AML achieve remission. Of those, from 20 to 50 percent have long-term survival with no relapse. The prognosis depends on the sub-type classification of AML according to the nature of the DNA defect. In addition to a favorable sub-type, other good indicators include being younger, having no history of cancer or previous blood disease, and a lower white blood cell count.

About this Author

In 20 years as a biologist, Susan T. McClure has contributed articles to scientific journals such as “Nature Genetics” and “American Journal of Physiology.” She earned her Ph.D. from the University of Maryland. She enjoys educating people about science and the challenge of making complex information accessible.