Acute Myeloid Leukemia (AML): Symptoms, Causes, Risk Factors, Diagnosis, Treatment

Medically Reviewed by Dr. K on 28 April 2021

Acute Myeloid Leukemia

Acute myeloid leukaemia (AML) is a form of cancer that affects the blood. It begins in the soft inner parts of the bones, called bone marrow. AML is most often found in cells that turn into white blood cells, but it may also start in other blood-forming cells.

Bone marrow cells don’t develop the way they’re meant to in acute leukemias like AML. Blasts, or immature cells, accumulate in the body.

Acute myeloid leukemia is also known by the following terms:

  • Acute myelocytic leukemia
  • Acute myelogenous leukemia
  • Acute granulocytic leukemia
  • Acute non-lymphocytic leukemia

AML can be life-threatening if it is not treated. It can easily spread to your blood and other areas of your body, like your:

  • Lymph nodes
  • Liver
  • Spleen
  • Brain and spinal cord
  • Testicles

The severity of your acute myeloid leukaemia depends on a number of factors, like how strongly it reacts to treatment. Your outlook would be better if:

  • You’re under the age of 60.
  • When you’re first diagnosed, your white blood cell count is lower.
  • You haven’t had any such blood disorders or cancers previously
  • You don’t have any chromosome or gene changes.

Causes and Risk Factors

Doctors are often clueless as to why someone develops AML. However, there are several factors that may increase the chances of getting it. Risk factors for acute myeloid leukaemia include:

  • Smoking
  • Coming into contact with chemicals such as benzene (a solvent used in cigarette smoke and used in oil refineries and other industries), pesticides, ionising radiation, and certain cleaning supplies, detergents, and paint strippers
  • Some chemotherapy drugs used to treat other cancers, such as cyclophosphamide, doxorubicin, melphalan, and mitoxantrone
  • Exposure to high doses of radiation
  • Certain blood conditions such as myeloproliferative disorders (for example, chronic myelogenous leukaemia)
  • A parent or sibling who had AML
  • Certain genetic syndromes such as Down syndrome, trisomy 8, neurofibromatosis type 1, and Li-Fraumeni syndrome.

While there is no way to avoid AML, you will reduce the chances by not smoking and restricting your contact with chemicals.

Symptoms

Flu-like symptoms are often the beginning signs of acute myeloid leukaemia. You might have:

  • Fatigue
  • Fever
  • Weight loss or loss of appetite
  • Headaches
  • Unusual bleeding or bruising
  • Small red spots on your skin (petechiae)
  • Swollen gums
  • Swollen liver or spleen
  • More infections than usual

Diagnosis

Your doctor will inquire into your medical history. A physical exam will be performed to check for indications of bleeding, bruising, or infection. You may be subjected to tests such as:

  • Blood tests. The number of each type of blood cell in your body is measured by a full blood count (FBC). Blast cells are detected using a peripheral blood smear.
  • Imaging tests. X-rays, CT scans, MRIs, and ultrasounds will let you see what’s going on inside your body. They can assist in the detection of infections or reveal whether cancer has spread to other areas of the body.
  • Bone marrow tests. Your doctor takes a sample of marrow, blood, and bone from your hip or breastbone using a needle. A specialist examines it under a microscope for signs of the disease.
  • Spinal tap. A lumbar puncture is another name for this procedure. A needle is used by the doctor to extract cerebrospinal fluid from around your spinal cord. It is examined by a specialist for leukaemia cells.
  • Genetic tests. Your leukaemia cells may be examined in a lab for gene or chromosome changes. The results will provide your doctor with more information regarding your AML, allowing them to assist you in selecting the best treatment option.

Treatments

Since acute myeloid leukaemia spreads rapidly, it’s important to start therapy as soon as possible. It will rely on a number of factors, including the type of AML you have, the extent to which it has spread, and your general health.

There will be two phases of treatment:

  • Remission induction therapy. This treatment aims to destroy leukaemia cells in your blood and bone marrow, putting you in remission and removing signs of the disease.
  • Consolidation therapy. This is also known as post-remission therapy or remission continuation therapy. Its aim is to eliminate all surviving leukaemia cells to prevent the disease from returning.

In either phase, you may receive one or more types of treatment:

  • Chemotherapy. Certain drugs have the ability to destroy cancer cells or prevent them from dividing. These medications may be taken orally, intravenously, or by injection into another area of the body.
  • Radiation. Cancer cells may also be killed by high-energy X-rays. A large machine may be used by your doctor to send radiation towards the cancer. They may even inject a radioactive needle, seed, or wire into the body, either directly on or near the cancer.
  • Stem cell transplant. Since AML therapy may also destroy healthy cells, you may get stem cells that can develop into blood cells. They may come from you or from someone else.
  • Targeted therapy. Drugs are used to target specific genes and proteins involved in cancer cell development and spread.
  • Other medications. Arsenic trioxide (Trisenox) and all-trans retinoic acid (ATRA) are drugs that target cancer cells in acute promyelocytic leukaemia, a type of AML.

You could also join in a clinical study with new treatments. Clinical trials are often used to test experimental medicines that aren’t yet accessible to the general public. If one of these studies is a suitable fit for you, your doctor will inform you.

Before you sign up for anything, find out what it entails and what the risks and benefits are.

Sources

Referenced on  27/4/2021 

  1. American Cancer Society: “What is acute myeloid leukemia?" “How is acute myeloid leukemia classified?" “What are the risk factors for acute myeloid leukemia?" “How is acute myeloid leukemia diagnosed?" “Treating Leukemia — Acute Myeloid (AML) Topics."
  2. Leukemia & Lymphoma Society: “Leukemia Facts & Statistics," “Acute Myeloid Lymphoma."
  3. National Cancer Institute: “Adult Acute Myeloid Leukemia Treatment (PDQ) — Patient Version.”
  4. Mayo Clinic: “Acute myelogenous leukemia.”
  5. Cancer Research UK: “Acute myeloid leukaemia (AML).”
  6. https://www.webmd.com/cancer/lymphoma/acute-myeloid-leukemia-symptoms-treatments#1

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