Acute Myelogenous Leukemia—Adult
(AML—Adult; Acute Myeloid Leukemia—Adult; Acute Myeloblastic Leukemia—Adult; Acute Granulocytic Leukemia—Adult; Acute Nonlymphoblastic Leukemia—Adult)
by Krisha McCoy, MS
Acute myelogenous leukemia (AML) is a cancer of the blood and bone marrow. With AML, the bone marrow makes abnormal blood cells including:
AML begins in immature myeloblasts and progresses very quickly. It may also be the end state of chronic myelogenous leukemia (CML).
Cancer occurs when cells in the body become abnormal. They divide without control or order. Leukemia is cancer of the white blood cells and their parent cells. Leukemia cells do not function normally. They cannot do what normal blood cells do. In this case, they can not fight infections. This means that the person is more likely to become infected with viruses or bacteria. The cancerous cells also overgrow the bone marrow. This forces other normal components, like platelets out. Platelets are needed to help the blood clot. As a result, people with leukemia may bleed more easily.
The cause of AML is unknown. However, smoking after age 60 doubles the risk of this condition.
Risk Factors TOP
Risk factors that increase your chance of developing AML include:
These symptoms may also be caused by other, less serious health conditions. See a doctor if you have any of the following:
Your doctor will ask about your symptoms and medical history. A physical exam will be done, paying particular attention to swelling of the liver and spleen. The doctor will also look for swelling in lymph nodes in the armpits, groin, or neck. You will likely be referred to an oncologist. This is a doctor who focuses on treating cancer.
Tests may include the following:
After AML is identified, it can be classified as one of eight subtypes. These subtypes are based on the type of cell from which leukemia developed. Classification is important. It can help make a prognosis and design a treatment plan.
Talk with your doctor about the best plan for you. Treatment of AML usually involves two phases:
Treatment options include:
Chemotherapy is the use of drugs to kill cancer cells. It may be given in many forms. This includes pill, injection, and via a catheter. The drugs enter the bloodstream and travel through the body. While this will focus on cancer cells, some healthy cells are also killed.
Some AML may spread to the brain and spinal cord. In this case, intrathecal chemotherapy may be used. Chemotherapy drugs are placed directly into the spinal column.
Radiation therapy involves the use of radiation to kill cancer cells and shrink tumors. For AML, external radiation therapy is used.
The radiation is directed at the tumor from outside the body. This type of treatment is used for AML that has spread, or may spread, to the brain and spinal cord. It can also be used to treat bone pain that comes from bone affected by the leukemia.
Chemotherapy With Stem Cell Transplant TOP
Chemotherapy is followed by a transplantation of stem cells (immature blood cells). These will replace blood-forming cells destroyed by cancer treatment. Stem cells are removed from the blood or bone marrow of the patient or a donor. They are then infused into the patient.
Other Drug Therapy TOP
These drugs may be used with certain types of leukemia. They can kill leukemia cells, stop them from dividing, or help them mature into white blood cells:
Monoclonal Antibody Therapy TOP
This therapy uses antibodies made in a lab. The antibodies help to identify substances on cancer cells or on normal cells that may help cancer grow. The antibodies attach to these substances. This kills the cancer cells, blocking their growth, or preventing them from spreading.
Biologic Therapy TOP
Biologic therapy uses medications or substances made by the body. The substance is used to increase or restore the body's natural defenses against cancer. This type of therapy is also called biological response modifier therapy. It is still being tested in clinical trials.
Treatment of Side Effects TOP
Patients will suffer side effects from the leukemia and from therapy. These include:
Anemia may lead to fatigue. If severe, it can complicate respiratory or cardiac disease. Thrombocytopenia may lead to bleeding and bruising. Decreased numbers of white blood cells can leave a patient more vulnerable to infection.
Your doctor may prescribe a number of different treatments to decrease these side effects. Drugs are available to increase production of normal blood cells. In addition, when your counts are particularly low, blood transfusions or changes in daily activities may be needed. These steps will reduce the chance of fatigue, bleeding, or infection.
Many people who develop AML have no risk factors. There is no way to prevent the condition in most people. However, 20% of cases are related to smoking tobacco. Not smoking is the best known way to prevent AML.
American Cancer Society
The Leukemia and Lymphoma Society
National Cancer Institute
BC Cancer Agency
Canadian Cancer Society
Adult acute myeloid leukemia (PDQ): treatment. National Cancer Institute website. Available at: http://www.cancer.... . Updated July 30, 2012. Accessed October 30, 2012.
Childhood acute myeloid leukemia/other myeloid malignancies (PDQ): treatment. National Cancer Institute website. Available at: http://www.cancer.... . Updated August 13, 2012. Accessed October 30, 2012.
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05/12/2014 DynaMed's Systematic Literature Surveillance
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Davis AS, Viera AJ, et al. Leukemia: an overview for primary care. Am Fam Physician. 2014 May 1;89(9):731-8.
Last reviewed December 2013 by Mohei Abouzied, MD
Last Updated: 5/12/2014