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Alternative Names: Myeloid Leukemia, Acute Myelocytic Leukemia, Acute Granulocytic Leukemia, and Acute Non-lymphocytic Leukemia.
AML is a cancer that starts in cells that would normally develop into different types of blood cells. Most cases of AML develop from cells that would turn into white blood cells (other than lymphocytes), but some cases of AML develop in other types of blood-forming cells. There are different types of AML. AML starts in the bone marrow, but in most cases it quickly moves into the blood. It can sometimes spread to other parts of the body including the lymph nodes, liver, spleen, central nervous system (brain and spinal cord), and testicles in males. "Acute" means that the leukemia can progress quickly, and if not treated, would probably be fatal in a few months.
AML results from acquired (not inherited) genetic damage to the DNA of developing cells in the bone marrow. The effects are: 1) the uncontrolled, exaggerated growth and accumulation of cells called "leukemic blasts" which fail to function as normal blood cells and 2) the blockade of the production of normal marrow cells, leading to a deficiency of red cells (anemia), and platelets (thrombocytopenia) and normal white cells (especially neutrophils, i.e. neutropenia) in the blood.
Incidence; Causes & Development; Risk Factors
About 10,600 new cases of acute myelogenous leukemia are diagnosed each year in the United States. Some 15% of childhood leukemia cases are of acute myelogenous leukemia.
AML is not contagious and is not inherited. AML can occur in a variety of ways; different types of cells may be seen by the physician in blood or marrow. Since most patients have one of seven different patterns of blood cell involvement, these patterns have formed a subclassification. Myeloblasts are undeveloped cells. If they are the dominant leukemic cells in the marrow at the time of diagnosis the leukemia is referred to as "myeloblastic" type. If there are many myeloblasts but there are some cells developing towards fully formed blood cells, the added designation "with maturation" is used. If there are cells that are developing features of monocytes ("monocytic" type) or red cells ("erythroleukemic"), these designations are used and so forth.
Even though the leukemia cells look somewhat like blood cells, the process of their formation is incomplete. Normal, healthy blood cells are insufficient in quantity.
In most cases the cause of AML is not evident. Several factors have been associated with an increased risk of disease. These include:- Exposure to high doses of irradiation, as carefully studied in the Japanese survivors of atomic bomb detonations
- Exposure to the chemical benzene, usually in the work place
- Exposure to chemotherapy used to treat cancers such as breast cancer, cancer of the ovary or the lymphomas.
Uncommon genetic disorders such as Fanconi anemia, Down syndrome and others are associated with an increased risk of AML. Older people are more likely to develop the disease. AML incidence increase dramatically among people who are over the age of 40. They are most prevalent in the sixth, seventh and eighth decades of life.
Signs & Symptoms
Most patients feel a loss of well-being. They tire more easily and may feel short of breath when physically active. They may have a pale complexion from anemia. Several signs of bleeding caused by a very low platelet count may be noticed. They include black-and-blue marks or bruises occurring for no reason or because of a minor injury, the appearance of pin-head sized spots under the skin, called petechiae, or prolonged bleeding from minor cuts. Mild fever, swollen gums, frequent minor infections like pustules or perianal sores, slow healing of cuts or discomfort in bones or joints may occur.
Diagnosis & Tests
To diagnose the disease the blood and marrow cells must be examined. In addition to low red cell and platelet counts, examination of the stained (dyed) blood cells with a light microscope will usually show the presence of leukemic blast cells. This is confirmed by examination of the marrow, which invariably shows leukemic blast cells. The blood and/or marrow cells are also used for studies of the number and shape of chromosomes (cytogenetic examination), immunophenotyping and other special studies, if required.
Treatment & Prevention
The subclassification of the disease is important. Different types of therapy may be used and the likely course of the disease may be different. Additional features may be important in guiding the choice of therapy, including: abnormalities of chromosomes, the cell immunophenotype, the age and the general health of the patient, and others.
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Signs, symptoms & indicators of Acute Myelogenous Leukemia (AML):
Conditions that suggest Acute Myelogenous Leukemia (AML):
Risk factors for Acute Myelogenous Leukemia (AML): | | | | | Addictions |  Cigarette Smoke Damage | There is a growing body of evidence linking smoking and cancer of the hematopoietic system. Between 20% and 30% of leukemia cases are related to smoking. In one study, smoking was associated among participants aged 60 and older with a twofold increase in risk for AML. [J Natl Cancer Inst. 1993 Dec 15;85(24): pp.1994-2003] |
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Acute Myelogenous Leukemia (AML) suggests the following may be present:
Acute Myelogenous Leukemia (AML) can lead to:
Recommendations and treatments for Acute Myelogenous Leukemia (AML):
KEY | | Weak or unproven link |  | | Strong or generally accepted link |  | | Proven definite or direct link |  | | Likely to help |
GLOSSARY
Acute
An illness or symptom of sudden onset, which generally has a short duration.
Anemia (Anaemia, Anemias)
A condition resulting from an unusually low number of red blood cells or too little hemoglobin in the red blood cells. The most common type is iron-deficiency anemia in which the red blood cells are reduced in size and number, and hemoglobin levels are low. Clinical symptoms include shortness of breath, lethargy and heart palpitations.
Bone Marrow
The soft inner part of the bones, where new blood cells are made.
Cancer
Refers to the various types of malignant neoplasms that contain cells growing out of control and invading adjacent tissues, which may metastasize to distant tissues.
Central Nervous System (CNS)
A collective term for the brain, spinal cord, their nerves, and the sensory end organs. More broadly, this can even include the
neurotransmitting hormones instigated by the CNS that control the chemical nervous system, the endocrine glands.
Chemotherapy
A treatment of disease by any chemicals. Used most often to refer to the chemical treatments used to combat cancer cells. Chemotherapy is usually given in cycles: a treatment period followed by a recovery period, then another treatment period, and so on. Most anticancer drugs are given by injection into a blood vessel (IV); some are given by mouth. Chemotherapy is a systemic therapy, meaning that the drugs enter the bloodstream and travel throughout the body. Usually, a patient has chemotherapy as an outpatient (at the hospital, at the doctor's office, or at home). However, depending on which drugs are given and the patient's general health, a short hospital stay may be needed.
DNA
Deoxyribonucleic acid, the large molecule that is the main carrier of genetic information in cells. DNA is found mainly in the chromosomes of cells.
Leukemia
Cancer of the lymph glands and bone marrow resulting in overproduction of white blood cells (related to Hodgkin's disease).
Liver (Hepatic)
The largest and one of the most complex organs of the body, the liver is responsible for much of the metabolism of fats, proteins and carbohydrates. It is the site of much of the body's detoxification. It is connected very closely with digestion and the regulation of blood sugar, among many other functions. Found behind the ribs on the right side of the abdomen, it has many important functions such as removing harmful material from the blood, making enzymes and bile that help digest food, and converting food into substances needed for life and growth. Hepatic: Pertaining to the liver.
Lymph Nodes (Axillary Nodes, Inguinal Nodes, Lymph Gland, Lymph Glands, Lymph Node, Lymphatic)
Small, bean-shaped nodes at various points throughout the body that function to filter the lymph fluid and attempt to destroy the microorganisms and abnormal cells which collect there. The most common locations are the neck (both sides and front), armpit (axillary) and groin (inguinal), but also under the jaw and behind the ears. Swollen or painful lymph nodes generally result from localized or systemic infection, abscess formation, or malignancy. Other causes of enlarged lymph nodes are extremely rare. Physical examination for lymph nodes includes pressing on them to check for size, texture, warmth, tenderness and mobility. Most lymph nodes can not be felt until they become swollen, and then will only be tender when pressed or massaged. A lymph node that is painful even without touching indicates greater swelling. Lymph nodes can usually be distinguished from other growths because they generally feel small, smooth, round or oval-shaped and somewhat mobile when attempts are made to push them sideways. Because less fat covers the lymph nodes in children, they are easier to feel, even when they are not busy filtering germs or making antibodies. Childrens' nodes enlarge faster, get bigger in response to an infection and stay swollen longer than an adult's. Also known (incorrectly) as lymph glands.
Lymphoma (Lymphomas)
Any tumor of the lymphatic tissues.
Neutrophils (Neutrophil)
Another name for polymorphonuclear leukocytes, the most common type of blood-carried white blood cell, and the first mobile resistance cell to come to the rescue in injury.
Ovary (Ovaries)
Ovaries are about the size of an almond and lie on either side of the lower abdomen beside the uterus. They usually produce one egg each month and whether the egg is fertilized or not, the reproductive process follows a monthly cycle, with constant changes in various hormone levels, preparing another opportunity for conception. The ovary is responsible for most of the estrogen production in women. At menopause (sometime after middle-age), egg production ceases and hormone levels drop significantly.
Platelets (Platelet)
Cells that help the blood to clot.
Spleen (Splenectomy)
The largest organ of the lymphatic system in the body, located between the stomach and the diaphragm (the muscle below the lungs which provides the motion for breathing). It destroys old red blood cells, produces lymphocytes and plasma cells, and stores blood. It also has other as yet unknown functions. A splenectomy is the surgical removal of the spleen.
Syndrome
A medical condition characterized by a collection of related symptoms (what the patient feels) and signs (what a doctor can observe or measure).
Testicles (Testicle, Testicular)
Egg-shaped sex glands in the scrotum that secrete male hormones such as testosterone, and produce sperm.
Thrombocytopenia
Condition of abnormally small number of platelets circulating in the blood, characterized by inability to properly clot blood and easy bruising.
White Blood Cell (WBC, White Blood Cells)
A blood cell that does not contain hemoglobin: a blood corpuscle responsible for maintaining the body's immune surveillance system against invasion by foreign substances such as viruses or bacteria. White cells become specifically programmed against foreign invaders and work to inactivate and rid the body of a foreign substance. White blood cells are composed primarily of neutrophils, monocytes and lymphocytes. Lymphocytes are either T-cells or B-cells. T-cells (CD3 cells) are divided into T-helper (CD4 cells) and T-suppressor/cytotoxic (CD8 cells) cells.
Last updated: Nov 14, 2009
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