Acute Myeloid Leukemia (AML), also called acute myeloid leukemia, a cancer of myeloid line of blood cell, which is characterized by rapid growth of abnormal white blood cells, that collect in the bone marrow and interfere with the production of normal blood cells. AML is the most common leukemia in adults, and its incidence increases with age.
The exact causes are undiscovered, although a number of risk factors for AML have been identified, including: other blood diseases, chemical exposures, radiation, and genetics.
Pre Leukemia : "Pre-leukemic" blood disorders such as myelodysplastic syndromes and myeloproliferative disorders may develop acute myeloid leukemia, the exact risk depends on the MDS / MPS.
Chemical Exposure : Getting expose to anti-cancer chemotherapy, including alkylating agents, increases the risk of subsequent development of AML. The highest risk is about 3-5 years after chemotherapy. Other chemotherapeutic agents, especially epipodophyllotoxins and anthracyclines, have also been associated with treatment-related leukemia. These treatment-related leukemias are often associated with chromosomal abnormalities in leukemic cells.
Occupational chemical exposure to benzene and other aromatic organic solvents is controversial as a cause of AML. Benzene and many of its derivatives are called carcinogens in vitro. Although some studies have suggested a link between occupational exposure to benzene and increased risk of AML, others have suggested that the attributable risk, if any, is minimal.
Radiation : Getting expose to Ionizing radiation can increase the risk of AML. The survivors of the atomic bombings of Hiroshima and Nagasaki was an increased rate of AML, as radiologists exposed to high levels of X-rays before the adoption of modern practices of radiation protection.
Genetics : A Family / hereditary risk for AML appears to exist. There are many reports of several cases of AML develop in a family with a higher rate than predicted by chance alone.The risk for developing AML have tripled in the first-degree relatives of patients with AML.
Several congenital conditions might increase the risk of leukemia, the most common is probably Down syndrome, which is associated with a 10 - to 18-fold risk of AML.
Most patients seek treatment because of an illness that can include
Patients are often ill for several days to weeks before seeking medical treatment.
The doctor performs the medical examination and search for swelling of the spleen, liver, groin, neck and lymph nodes. The doctor will prescribe the test CBC, which is a complete blood count measures the number of red and white blood cells and platelets. In addition, samples of blood examined under a microscope to see what the cells look and to determine the number of mature blood cells and leukemia cells, called blasts. Although blood tests can reveal that the patient has leukemia, are not always show what kind of leukemia.
To further verify the leukemia cells or to identify this type of leukemia the patient, a hematologist (a specialist in blood disorder) or an oncologist (cancer specialist) performs a bone marrow aspiration and biopsy. During this procedure, the doctor inserts a needle into a large bone (usually the hip) and removing a small amount of bone marrow fluid (aspiration) and a piece of spongy tissue inside the bone (biopsy). The procedure takes about 20 minutes. After the biopsy and aspiration to obtain the hematologist, oncologist, or pathologist examines the sample under a microscope.
Other studies such as peroxidase stain and / or immunophenotype may be needed to confirm the diagnosis and reveal the precise acute myeloid leukemia (AML) subtype. Also, a small amount of bone marrow fluid is sent to a special chromosome test known as cytogenetics, which can sometimes reveal important information about the treatment and prognosis.
Leukemia is treated mainly with chemotherapy, although radiotherapy and biological therapy can play an important role in certain situations. Aims of treatment are to relieve symptoms and put the leukemia into remission and hopefully cure the disease.
Active therapy of leukemia is usually divided into two phases:
1. Induction : This is an attempt to obtain the remission of the leukemia.Standard induction therapy of acute myeloid leukemia includes two drugs: an anthracycline (such as daunorubicin or idarubicin) in combination with a nucleoside analogue, cytosine arabinoside. These drugs are administered intravenously for seven days, the most common induction. Supportive therapy (including anti-nausea medications) is required during the initial hospitalization for induction therapy, which often lasts up to a month.
Chemotherapy drugs kill normal bone marrow and leukemic cells equally, hence the most significant side effects besides nausea and vomiting are a temporary reduction of white blood cells, platelets and red blood cells. The lack of white blood cells and the integrity of the results was calculated the probability of infection. Low platelet counts can easily lead to bruisability and spontaneous bleeding, and treated with routine platelet transfusions. The decrease in red blood cells is called anemia can cause fatigue, shortness of breath, and lack of energy. Transfusions of red blood cells are therefore used routinely.
2. Consolidation : It is repeated cycles of chemotherapy administered when the patient seems to be in remission. The purpose of the consolidation chemotherapy is to remove all microscopic amounts of leukemia that are undetectable using standard diagnostic tests.
Stem cell transplantation is used in place of the individual consolidated chemotherapy adverse prognostic features at diagnosis of leukemia. Stem cell transplantation is also used to try to improve the acute myeloid leukemia who have relapsed after standard chemotherapy.
It is also important to consider alternatives to standard therapy for some individuals with acute myeloid leukemia. In the very elderly, the cure rate of acute myeloid leukemia is very low, so consideration of palliative and supportive care is a reasonable option.