AML

AML (acute myeloid leukemia) accounts for about 10,600 new cases of leukemia each year, and it occurs in both adults and children. Common AML symptoms may include fever (with or without an infection), shortness of breath, and weakness or fatigue. Current AML treatment options include chemotherapy, radiation therapy, stem cell transplantation, and other drug therapies.

 

AML: An Overview

Acute myeloid leukemia (AML) is a cancer of the blood and bone marrow. AML usually progresses quickly if it is not treated. AML accounts for about 10,600 new cases of leukemia each year, and it occurs in both adults and children.
 
Other names for acute myeloid leukemia or AML are:
 
  • Acute myelogenous leukemia
  • Acute myeloblastic leukemia
  • Acute granulocytic leukemia
  • Acute non-lymphocytic leukemia.
 
This eMedTV article discusses AML for both children and adults. You can click Childhood AML for more information on childhood AML or Adult Acute Myeloid Leukemia for more information on adult AML. You can also click Types of Leukemia to learn more about other leukemia types.
 

Understanding AML and Blood Cells

Normally, the body produces bone marrow stem cells (immature cells) that develop into mature blood cells.
 
The three types of mature blood cells include:
 
  • Red blood cells that carry oxygen and other materials to all tissues of the body
  • White blood cells that fight infection and disease
  • Platelets that help prevent bleeding by causing blood clots to form.
 
In AML:
 
  • The stem cells usually develop into a type of white blood cell called myeloblasts (or myeloid blasts)
 
  • The myeloblasts (or leukemia cells) are abnormal and do not mature into healthy white blood cells
 
  • Leukemia cells are unable to do their usual work and can build up in the blood and bone marrow so there is less room for healthy white blood cells, red blood cells, and platelets.
 
This may lead to infection, anemia, or easy bleeding. The leukemia cells can spread outside the blood to other parts of the body, including the central nervous system (brain and spinal cord), skin, and gums.
 

Subtypes of AML

There are different subtypes of AML that are based on:
 
  • The type of blood cell that is affected
  • How mature (developed) the cancer cells are at the time of diagnosis
  • How different they are from normal cells.
 
The treatment for most subtypes of AML is similar. However, acute promyelocytic leukemia is one subtype of AML that is treated differently from other types of AML.
 

Risk Factors for AML

No one knows what causes acute myeloid leukemia, and doctors can seldom explain why one person will get AML and another person will not. However, leukemia research has shown that people with certain risk factors are more likely than others to develop AML. A risk factor is anything that increases a person's chance of developing a disease.
 
Childhood AML risk factors include:
 
  • Having a brother or sister, especially a twin, with leukemia
  • Being Hispanic
  • Being exposed to cigarette smoke or alcohol before birth
  • Having a history of myelodysplastic syndrome (pre-leukemia) or aplastic anemia
  • Past treatment with chemotherapy or radiation therapy
  • Being exposed to ionizing radiation or chemicals such as benzene
  • Having certain genetic disorders, such as Down syndrome.
 
Risk factors for adult AML include:
 
  • Being male
  • Smoking, especially after age 60
  • Having had treatment with chemotherapy or radiation therapy in the past
  • Having had treatment for childhood acute lymphocytic leukemia (ALL) in the past
  • Being exposed to atomic bomb radiation or the chemical benzene
  • Having a history of a blood disorder such as myelodysplastic syndrome.
 

Symptoms of AML

Like all blood cells, leukemia cells travel through the body. Depending on the number of abnormal cells and where these cells collect, patients with AML may have a number of AML symptoms.
 
Common childhood AML symptoms may include:
 
  • Fever with or without an infection
  • Shortness of breath
  • Weakness or feeling tired
  • Easy bruising or bleeding
  • Petechiae (flat, pinpoint spots under the skin caused by bleeding)
  • Pain in the bones or joints
  • Pain or feeling of fullness below the ribs.
 
Other common childhood AML symptoms include painless blue or purple lumps in the neck, underarm, stomach, groin, or other parts of the body. These lumps are called leukemia cutis. In some cases, painless lumps appear around the eyes. These lumps, called chloromas, may be blue-green.
 
The early signs of adult AML may be similar to those caused by the flu or other common diseases. Common symptoms of adult AML include:
 
  • Fever
  • Shortness of breath
  • Easy bruising or bleeding
  • Petechiae (flat, pinpoint spots under the skin caused by bleeding)
  • Weakness or feeling tired
  • Loss of appetite or weight loss.
 
These and other possible symptoms of AML may be caused by leukemia or by other conditions. Therefore, people with possible symptoms of AML should see their doctor for proper diagnosis and treatment.
 

Diagnosing AML

Tests that examine the blood and bone marrow are used to detect and diagnose AML.
 
(Click AML Diagnosis for more information about the specific tests used to diagnose AML.)
 

Stages of AML

Once AML has been diagnosed, tests are done to find out if the cancer has spread to other parts of the body. The extent or spread of cancer is usually described as stages. However, in AML there is no standard staging system. Instead, AML is described as untreated, in remission, or recurrent. In AML, the subtype of AML and whether the leukemia has spread outside the blood and bone marrow are used to plan AML treatment.
 

Treatment of AML

Different types of treatment are available for patients with AML. Some treatments are standard (the currently used treatment), and some treatments are being tested in clinical trials.
 
Current childhood AML treatment options include:
 
  • Chemotherapy
  • Radiation therapy
  • Chemotherapy with stem cell transplant.
 
There are also two phases of treatment used for childhood AML: induction therapy and consolidation/intensification therapy
 
Current adult AML treatment options include:
 
  • Chemotherapy
  • Radiation therapy
  • Stem cell transplantation
  • Other drug therapies.
 
There are also two phases of treatment for adult AML: remission induction therapy and maintenance therapy.
 
Choosing the most appropriate treatment for AML is a decision that ideally involves the patient, the family, and the healthcare team.
 

The Prognosis for AML

The prognosis and treatment options for AML will depend on:
 
  • The patient's age, general health, and number of white blood cells present at diagnosis
  • Whether the AML was caused by previous anticancer treatment
  • The subtype of AML
  • How well the leukemia responds to initial treatment
  • Whether the AML is untreated or has recurred (come back) after being treated
  • Whether there is a history of a blood disorder such as myelodysplastic syndrome
  • Whether the AML has spread to the central nervous system (brain and spinal cord) or to other parts of the body.
 

AML: Summary

Key information about AML includes:
 
  • Acute myeloid leukemia (AML) is a type of cancer in which the bone marrow makes a large number of abnormal blood cells
 
  • There are different subtypes of AML
 
  • Tests that examine the blood and bone marrow are used to detect and diagnose AML
 
  • Certain factors affect AML prognosis and treatment options
 
  • The American Cancer Society estimated that 11,960 people (6,530 men and 5,430 women) would be diagnosed with acute myeloid leukemia in 2005.
 
(Click Acute Myeloid Leukemia Statistics for more AML statistics.)
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Written by/reviewed by: Arthur Schoenstadt, MD
Last reviewed by: Arthur Schoenstadt, MD