LEUKEMIA ACUTE MYELOID (AML)

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Haematology , Oncology

Also known as Acute myelogenous leukemia, Acute myeloblastic leukemia, Acute granulocytic leukemia, and Acute nonlymphocytic leukemia.

ABOUT THE DISEASE

Leukemia is a cancer of the blood and bone marrow caused due to the over production of white blood cells (cells which fight off infections and diseases). This develops in the immature or developing cells of the bone marrow. This area is responsible for the development of a host of cells including Red Blood Cells (RBC) -essential for carrying oxygen, Platelets - essential for blood clotting and White Blood Cells (WBC)- essential to fight infections.

The cancerous cells prevent healthy red cells, platelets, and mature white cells (leukocytes) from being made causing life-threatening symptoms to develop.

Each of these types of Leukemias are divided into two major forms:
• Acute (which progresses quickly)
• Chronic (which progresses more slowly)

Leukemia are classified by the specific type of white blood cell involved.

Acute myeloid leukemia (AML) is a type of cancer in which the bone marrow makes abnormal myeloblasts (a type of white blood cell), red blood cells, or platelets. It is the most common type of acute leukemia in adults. 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.

There are various subtypes of AML, like Acute promyelocytic leukemia , Acute Myelomonocytic leukemia, Acute Monocytic leukemia, Acute erythroid leukemia, Acute megakaryocytic leukemia.

SYMPTOMS

• Poor appetite.
• Tiring easily.
• Shortness of breath.
• Low-grade fevers.
• Bone pain.
• Joint pain.
• Pale skin.
• Bruising.
• Nosebleeds and easy bleeding from minor cuts.
• Swollen glands.
• Weight loss.
• Swollen gums.
• Slow healing of cuts.

CAUSES

Although no specific causes have been identified, it is caused when the DNA of a single cell in the bone marrow mutates and becomes damaged. This changes the cell`s ability to develop and function normally. Further, all cells that arise from that initial cell also have the mutated DNA. What causes this mutation is unknown.

Certain factors that may put a person at higher risk are- very high doses of radiation, smoking, history of myelodysplastic syndrome, and exposure to certain chemotherapy drugs and chemicals like benzene.

DIAGNOSIS

- Physical examination
- CBC (complete blood count)
- Blood film examination
- Bone marrow biopsy along with a cytogenetics analysis

TREATMENT METHODS

It is planned on the basis of age of patient, subtype, spread of disease, etc.

The 2 treatment phases of AML are:

Remission induction therapy: This is the first phase of treatment. Its purpose is to kill the leukemia cells in the blood and bone marrow. This puts the leukemia into remission.

Post-remission therapy: This is the second phase of treatment. It begins after the leukemia is in remission. The purpose of post-remission therapy is to kill any remaining leukemia cells that may not be active but could begin to regrow and cause a relapse. This phase is also called remission continuation therapy.

The treatment used in these phases include:

- Chemotherapy alongwith frequent transfusions of red blood cells and platelets
- Radiotherapy
- Bone Marrow Transplant