Acute myeloid leukemia is a rare cancer that affects white blood cells in the bone marrow, causing abnormal cell production and reducing normal blood cell production. It is difficult to treat, especially in older patients, and can be caused by conditions such as Down syndrome, radiation exposure, and chemotherapy. Symptoms include flu-like symptoms, fatigue, and reduced immunity. Treatment involves two phases of chemotherapy, but only 20-30% of patients are cured.
Acute myeloid leukemia (AML) is a rare form of cancer that affects the white blood cells formed in the bone marrow. Myeloid means ‘from the bone marrow’ and in this form of cancer, the bone marrow starts producing abnormal or atypical cells. These new cancer cells interfere with the normal production of blood cells, reducing the production of red and white blood cells and platelets.
This form of cancer remains difficult to treat because only a few patients are strong enough to undergo the aggressive chemotherapy used to treat it. Younger patients are likely to have a higher survival rate, but older patients, the population where the disease is most prevalent, are less likely to respond to treatment.
Some conditions are more likely to cause acute myeloid leukemia. It is 10 to 18 times more likely to occur in people with Down syndrome. Ironically, chemotherapy treatment for other cancers can increase your risks of developing the condition. Additionally, radiation exposure is a common cause, and large numbers of people who survived the atomic bombings of Hiroshima and Nagasaki later developed the condition. Some current studies suggest that repeated exposure to the chemical benzene may also increase your risk.
Early symptoms of acute myeloid leukemia may not always suggest the disease. People may feel like they have the flu and have body aches, feelings of fatigue, fever, loss of appetite, and weight loss. Because more abnormal white blood cells inhibit normal blood cell production, symptoms such as difficulty breathing, reduced immunity to disease, frequent infections, and tiny rashes called petechiae can emerge.
Often people are not diagnosed accurately until they have a complete blood count (CBC) which shows abnormal counts of all blood cells. When a complete blood count shows lower than normal blood cell counts, medical professionals can extract a small amount of bone marrow to analyze the types of white blood cells that are abnormal. This is sometimes unnecessary, as abnormal blood cells can easily be found in the bloodstream if the disease is in an advanced stage.
Treatment involves two phases of chemotherapy. The first, called the induction phase, involves seven days of continuous intravenous injections of chemotherapy drugs such as cytarabine. The goal is to attack any abnormal white blood cells and hopefully reduce them to levels that can’t be detected.
The second stage of treatment is called post-remission or consolidation treatment. Patients who survive the induction phase often have a bone marrow transplant and receive three to five more chemotherapy treatments to kill the remaining cells. Hospitalization is usually required for both phases of treatment as resistance to infections is very low and high doses of chemotherapy can have adverse effects on the body.
AML is unfortunately difficult to treat, with only about 20-30% of patients cured. These statistics may actually be slightly off, since many elderly patients choose not to treat the condition at all when survival is unlikely. The condition remains a rare form of cancer, but medical researchers expect an increase in cases because people are living longer: the disease is more likely to affect those who are older, and the average age of onset is 63.
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