Acute myeloid leukemia (AML) is a type of leukemia, a cancer of the blood and bone marrow. AML specifically affects the myeloid cells, which are immature white blood cells. It is one of the most common types of adult leukemia.
There are several subtypes of acute myeloid leukemia. The most common are:
- Myeloid leukemia: The most common subtype
- Acute monocytic leukemia: Affects white blood cells.
- Acute megakaryocytic leukemia: Affects red blood cells or platelets
- Acute promyelocytic leukemia: Affects white blood cells
Acute myeloid leukemia causes several vague symptoms that could be similar to those of many other conditions. These more general symptoms of AML may include:
- Fatigue
- Fever
- Night sweats
- Loss of appetite
- Unintended weight loss
People with AML have a shortage of healthy blood cells. Low levels of blood cells may cause the following complications and their symptoms:
- Low red blood cells (anemia): Fatigue, weakness, pale skin, dizziness, lightheadedness, feeling cold, and shortness of breath
- Low white blood cells (neutropenia): Frequent infections and fevers
- Low platelets (thrombocytopenia): Easy bruising and bleeding, nose bleeds, heavy menstrual periods
Symptoms of Advanced AML
As acute myeloid leukemia progresses, it may affect other areas of the body. Symptoms of advanced AML may include:
- Bone or joint pain
- Abdominal swelling
- Skin rashes
- Headaches
- Seizures
- Blurred vision
AML starts in immature myeloid cells known as myeloblasts. As the cancerous myeloblasts divide and multiply, they begin to crowd out the healthy cells in the bone marrow, leading to low levels of red blood cells and platelets.
AML occurs when DNA changes take place inside chromosomes in the cells. A genetic mutation in the cells in the bone marrow can lead to leukemia. Researchers aren’t certain what causes these mutations, but there are certain risk factors that may be involved.
Risk Factors
Certain factors increase the risk of acute myeloid leukemia, some of which aren’t possible to avoid. You may be at a higher risk for AML if you:
- Are over 65
- Were assigned male at birth
- Smoke
- Have a history of chemotherapy or radiation therapy
- Are exposed to certain chemicals, like benzene
- Have a family history of AML
- Have certain genetic disorders like Down syndrome, neurofibromatosis, or Fanconi anemia
- Have certain blood disorders like myeloproliferative disorders (blood disorders that cause a low blood cell count and abnormal cells in the blood and bone marrow)
If you go to a primary care provider, they may refer you to an oncologist (a doctor who specializes in diagnosing and treating cancer) for testing.
In addition to performing a thorough physical exam and medical history, they may recommend the following diagnostic tests:
- Blood tests: These could include a complete blood count test to determine the amount of blood cells, a blood smear to look for myeloblasts in the blood, blood chemistry tests to check organ function, and coagulation tests to check platelet counts. They may also do genetic blood tests to look for genetic and chromosomal changes in the cells.
- Bone marrow tests: This is when a doctor takes out a small sample of bone marrow and examines the cells under a microscope.
- Cerebrospinal fluid test: A lumbar puncture is the most common way a doctor will perform this test. It measures whether cancer cells have spread to the brain or spinal cord.
Because AML doesn’t typically cause tumors, imaging scans aren’t used in the initial diagnostic steps. However, once you’ve been diagnosed, X-rays, ultrasounds, computed tomography (CT) scans, and magnetic resonance imaging (MRI) scans could be used to see if the cancer has spread or if you have any complications like a lung infection.
Stages of AML
Unlike other types of cancer, acute myeloid leukemia does not have a standard staging system. Cancer staging refers to the process of determining how advanced cancer is. This is helpful for determining a person’s prognosis and appropriate treatment plan. Most cancer staging protocols are based on the growth of a solid tumor. AML does not cause tumors.
While acute myeloid leukemia grows and spreads quickly, treatment is available. The goal of AML treatment is to achieve remission or slow the spread.
AML treatment options may include:
- Chemotherapy: This treatment uses drugs that destroy fast-growing cells in the body, including leukemia cells.
- Radiation therapy: This treatment uses radiation beams to destroy cancer cells.
- Targeted therapy: This treatment uses drugs that destroy specific types of cancer cells while sparing healthy cells. It’s usually used in combination with chemotherapy.
- Bone marrow transplant: This medical procedure replaces a person’s blood-making cells with those from a healthy donor.
There is no known way to prevent AML. Many people who develop AML do not have any risk factors. Because smoking is a known risk factor, quitting or avoiding smoking tobacco may lower your risk.
Even after successful treatment, you may still have complications of AML. These include:
- Fatigue
- Mental health concerns
- Infections
- Sexual dysfunction
- Recurrence of the cancer
If your treatment involved hematopoietic stem cell transplantation, you may also experience chronic graft-versus-host disease (GVHD). This is when the donor’s immune cells (the graft) attack the recipient’s body (host).
While acute myeloid leukemia is treatable, it may not be possible to cure. After treatment, AML may recur (come back).
The five-year survival rate for AML is 32.9%. That means that after their initial diagnosis, nearly 33% of people with AML are still alive after five years.
Consider the following recommendations for living with AML:
- Go to follow-up appointments: See your healthcare team for follow-up appointments and screening tests. Regular care helps your doctor recognize the first signs of recurrence and begin treatment right away.
- Make lifestyle changes: Talk with your healthcare team about diet and exercise recommendations. Staying active and eating a nutritious diet may improve your energy levels.
- Get emotional support: It is common to feel sad, angry, and overwhelmed during your cancer journey. Consider meeting with a therapist or support group.
Living with AML can be overwhelming. Stay in close contact with your healthcare team, and lean on friends and family members for support.
