Acute myeloid leukemia (AML) is a rare form of cancer that affects white blood cells formed in the bone marrow. Myeloid means “from the bone marrow,” and in this form of cancer, the bone marrow begins to produce abnormal or atypical cells. These new, cancerous cells interfere with the normal production of blood cells, which decreases red and white blood cell and platelet production.
This form of cancer remains challenging to treat because only a few patients are strong enough to undergo the aggressive chemotherapy used to cure it. Younger patients are likely to have a higher survival rate, but older patients, the population among which 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’s Syndrome. Ironically, treatment with chemotherapy for other cancers can increase risks of developing the condition. Further, radiation exposure is a common cause, and high numbers of people who survived the Hiroshima and Nagasaki atomic bombings later developed the condition. A few current studies suggest that repeated exposure to the chemical benzene may increase the risk as well.
The early symptoms of acute myeloid leukemia may not always suggest the illness. People may feel like they have the flu and have aching muscles, feelings of fatigue, fever, a loss of appetite, and weight loss. As more abnormal white cells inhibit normal blood cell production, symptoms like difficulty breathing, reduced immunity to illnesses, frequent infections, and tiny rashes on the skin called petechiae may emerge.
Often people are not accurately diagnosed until they have a complete blood count (CBC) that displays abnormal counts of all blood cells. When a CBC exhibits lower than normal counts of blood cells, medical professionals may extract a small amount of bone marrow to analyze the types of white blood cells that are abnormal. This is sometimes unnecessary, since abnormal blood cells may be readily found in the bloodstream if the disease is in a late stage.
Treatment has two phases of chemotherapy. The first, called the induction phase, involves seven days of continuous intravenous injections of chemo medications like cytarabine. The goal is to attack all abnormal white cells and hopefully to reduce them to levels that can’t be detected.
The second phase of treatment is called post-remission or consolidation treatment. Patients who survive the induction phase often undergo a bone marrow transplant, and receive three to five more treatments of chemotherapy in order to kill remaining cells. Hospitalization is normally necessary for both phases of treatment since resistance to infection is very low, and the high doses of chemotherapy can have adverse effects on the body.
Acute myeloid leukemia is unfortunately difficult to treat, with only about 20 to 30% of patients cured. These statistics may actually be slightly off, since many elderly patients elect not to treat the condition at all when survival is unlikely. The condition remains a rare form of cancer, but medical researchers expect a rise in cases because people are living longer: the disease is most likely to affect those who are elderly, and the average age of onset is 63.