About the disease
Acute myeloid leukemia is a cancer of blood cells, which develops in the bone marrow, where blood cells are produced. AML tends to progress rapidly and can metastasize to lymph nodes and central nervous system. In some cases, it can also spread to liver and spleen.
AML develops in myeloid cells responsible for forming red and white blood cells. Myeloid cells become malignant when they start to multiply abnormally and block development of healthy blood cells. Such abnormal blood cells are also known as immature blasts, as they keep dividing when they should have stopped to allow new blood cells develop.
According to American Cancer Society, there are approximately 21,380 new cases of AML registered annually in the USA. It is more common in people over 45 years of age. In rare cases, AML affects children and their survival rates are much higher than in adults. It is more common in men.
Although the exact cause for AML has not been determined yet, smoking is considered one of the leading risk factors for this disease. It can be explained by the fact that smoke substances easily enter the bloodstream and affect the blood cells. Tobacco consumption is considered more dangerous than cigarettes as it spreads through the bloodstream easier. It can also be caused by previous radiation exposure and chemotherapy. Certain genetic blood disorders, which affect myeloid cells, can also cause development of AML.
Symptoms
- Fatigue
- Weight loss
- Headaches
- Decreased appetite
- Dizziness
- Lightheadedness
- Frequent nose bleeding
- Long healing wounds and bruises
- Vomiting
Diagnosis
- Blood test is generally used as the first measure if there is a suspicion for AML. It determines if a person has abnormal amount of white and red blood cells in the bloodstream. It can also rule out the possibility of anemia and other blood diseases.
- Bone marrow biopsy is used to confirm the diagnosis and determine the stage of AML. It can also determine the type of leukemia, if it has not been determined yet that a patient has acute myeloid leukemia.
- MRI and CT scan of other organs are used if there is suspicion that AML has metastasized to lungs, liver or brain.
Treatment
- High-intensity induction chemotherapy is considered to be the main treatment for AML, as it is impossible to resect and shrink this type of cancer. There are several effective chemotherapy drugs, designed specifically for AML treatment, which are usually able to kill the majority of cancerous cells. It is especially effective at the beginning stages of AML.
- Consolidation treatment is usually used after the first induction therapy to kill the remaining part of immature blasts, which have not been reached by induction therapy. It is usually given through the injection into the vein and is applied after the patient recovered from initial induction therapy.
- Radiation therapy of brain is primarily used if AML has spread to the brain. There can be one or several courses of radiation, depending on the stage of cancer progression.
- Stem cells transplantation is used if the abnormal division of blood cells in the bone marrow is absolutely irreversible and cannot be improved after chemotherapy. In this case, a patient undergoes transplantation of healthy stem cells from the donor, which tissue type must be similar to the type of a patient. Usually, relatives and people with similar DNA are the best matches for this type of therapy.
Authors: Dr. Vadim Zhiliuk, Dr. Sergey Pashchenko
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