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Acute Myelogenous Leukemia

Overview

Acute myelogenous leukemia (AML) is a cancer of the blood and bone marrow — the spongy tissue inside bones where blood cells are made.

The word "acute" in acute myelogenous leukemia denotes the disease's rapid progression. It's called myelogenous (my-uh-LOHJ-uh-nus) leukemia because it affects a group of white blood cells called the myeloid cells, which normally develop into the various types of mature blood cells, such as red blood cells, white blood cells and platelets.

Acute myelogenous leukemia is also known as acute myeloid leukemia, acute myeloblastic leukemia, acute granulocytic leukemia and acute nonlymphocytic leukemia.

Causes and Risk Factors

Doctors often don’t know why someone gets AML. But some things may make you more likely to get it. Acute myeloid leukemia risk factors include:

Smoking

Coming into contact with certain chemicals such as benzene (a solvent that’s used in oil refineries and other industries and that’s found in cigarette smoke), pesticides, ionizing radiation, some cleaning products, 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 leukemia)

A parent or sibling who had AML

Certain genetic syndromes such as Down syndrome, trisomy 8, neurofibromatosis type 1, and Li-Fraumeni syndrome.

There’s no way to prevent AML, but you may lower your risk by not smoking and limiting your contact with chemicals.

The signs and symptoms of acute myeloid leukemia (AML) are common to other, less serious illnesses. However, if you're troubled by any of the following symptoms, see your doctor: 

It is common for people with AML to feel a loss of well-being because of the underproduction of normal bone marrow cells. 

Symptoms of a low red blood cell count (called “anemia”) include:

  • Fatigue
  • Weakness
  • Shortness of breath during normal physical activities
  • Lightheadedness, dizziness or faintness
  • Headaches
  • Pale complexion
  • Symptoms of a low white blood cell count (called “neutropenia”) include:
  • Frequent infections
  • Fever

Symptoms of a low platelet count (called “thrombocytopenia”) include:

  • Bruising easily
  • Pinhead-sized red spots on the skin, called “petechiae”
  • Prolonged bleeding from minor cuts
  • Frequent or severe nosebleeds
  • Bleeding gums
  • Other general symptoms of AML include:
  • Loss of appetite
  • Unexplained weight loss
  • Discomfort in bones or joints
  • Fullness or swelling in the abdomen, due to an enlarged spleen or liver

Diagnosis

If you have signs or symptoms of acute myelogenous leukemia, your doctor may recommend that you undergo diagnostic tests, including:

Blood tests. Most people with acute myelogenous leukemia have too many white blood cells, not enough red blood cells and not enough platelets. But sometimes the level of white blood cells can be too low. The presence of blast cells — immature cells normally found in bone marrow but not circulating in the blood — is another indicator of acute myelogenous leukemia.

Bone marrow test. A blood test can suggest leukemia, but it usually takes a bone marrow test to confirm the diagnosis.

During a bone marrow biopsy, a needle is used to remove a sample of your bone marrow. Usually, the sample is taken from your hipbone. The sample is sent to a laboratory for testing.

Lumbar puncture (spinal tap). In certain situations, it may be necessary to remove some of the fluid around your spinal cord to check for leukemia cells. Your doctor can collect this fluid by inserting a small needle into the spinal canal in your lower back.

Testing your cancer cells in the laboratory. In a laboratory, doctors test your leukemia cells to better understand which gene mutations are present. This can help determine your prognosis and guide your treatment.

If your doctor suspects leukemia, you may be referred to a doctor who specializes in blood cancer (hematologist or medical oncologist).

Determining your AML subtype

If your doctor determines that you have AML, you may need further tests to determine the extent of the cancer and classify it into a more specific AML subtype.

Your AML subtype is based on how your cells appear when examined under a microscope. Special laboratory testing also may be used to identify the specific characteristics of your cells.

Your AML subtype helps determine which treatments may be best for you. Doctors are studying how different types of cancer treatment affect people with different AML subtypes.

Determining your prognosis

Your doctor uses your AML subtype and other information to determine your prognosis and decide on your treatment options. Other types of cancer use numerical stages to indicate your prognosis and whether your cancer has spread, but there are no stages of acute myelogenous leukemia.

Instead, the seriousness of your condition is determined by:

  • AML subtype
  • Your age
  • Your overall health

Results from other tests and procedures, such as the number of white blood cells found in a blood sample

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