Acute Myelogenous Leukemia

Acute Myelogenous Leukemia (AML) is a type of blood cancer that starts in the bone marrow. The bone marrow is the spongy tissue inside bones where blood cells are made.

The word "acute" means AML tends to progress quickly. "Myelogenous" means it affects myeloid cells, which normally develop into different types of blood cells: red blood cells that carry oxygen, white blood cells that fight infection, and platelets that help blood clot.

AML is the most common type of fast-growing blood cancer (acute leukemia) in adults. A different type of acute leukemia is acute lymphoblastic leukemia (ALL). While AML can happen at any age, it's less common before age 45. AML is sometimes also called acute myeloid leukemia, acute myeloblastic leukemia, acute granulocytic leukemia, or acute nonlymphocytic leukemia.

Unlike some other cancers, AML doesn't have stages numbered 1, 2, etc.

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Acute myelogenous leukemia (AML) is a type of blood cancer. Some common signs of AML include:

• Fever: A high temperature is a possible sign.
• Pain: You might feel pain in your bones, back, or stomach.
• Extreme tiredness: Feeling unusually fatigued or weak.
• Changes in skin color: Your skin might look paler than usual, or you might notice a change in its color.
• Frequent infections: Getting sick more often than usual.
• Easy bruising: Small bumps or marks on your skin that appear easily, without a noticeable cause.
• Unexplained bleeding: Nosebleeds, bleeding gums, or bleeding from other areas without a clear reason.
• Shortness of breath: Difficulty breathing comfortably.

These symptoms can also be caused by other, more common illnesses, such as infections. If you're experiencing any of these symptoms, it's important to see a doctor. They can figure out the cause and give you the best treatment. Don't delay in seeking medical advice if you have ongoing symptoms that concern you.

If you're experiencing ongoing health problems that concern you, it's important to schedule a visit with your doctor. Symptoms of acute myeloid leukemia (AML) can be similar to symptoms of much more common illnesses, like infections. Your doctor may first investigate whether a more common condition is causing your symptoms. So, if you're worried about your health, don't hesitate to make an appointment.

Acute myelogenous leukemia (AML) often has no clear cause. Doctors know it begins when something goes wrong with the DNA inside the bone marrow cells. The bone marrow is the soft, inner part of bones where blood cells are made.

These problems are believed to happen in special bone marrow cells called myeloid cells. Myeloid cells are like a type of construction crew, able to build different kinds of blood cells. Normal myeloid cells can create:

• Red blood cells: These carry oxygen throughout your body.
• Platelets: These help your blood clot and stop bleeding.
• White blood cells: These fight off infections.

Every cell in your body has DNA, which acts like a set of instructions telling the cell what to do. In healthy cells, this DNA tells cells to grow and multiply at a specific pace, and to die at a specific time. However, when changes happen to the DNA in myeloid cells, the instructions change. This causes the myeloid cells to make many extra cells, and they don't stop.

These DNA changes cause the myeloid cells to produce a lot of immature white blood cells called myeloblasts. These myeloblasts aren't fully developed and don't function properly. They can accumulate in the bone marrow, pushing out healthy blood cells. When there aren't enough healthy blood cells, you might have low oxygen levels, which can cause problems like fatigue; easy bruising or bleeding; and a higher risk of getting sick.

Things that might make some people more likely to get acute myeloid leukemia (AML) include:

• Getting older: AML is most often found in adults who are 65 years old or older. As you age, your body's cells may be more prone to mistakes during division, which can sometimes lead to cancer.

• Previous cancer treatment: Some chemotherapy and radiation treatments can damage cells, increasing the risk of developing a second cancer like AML later on. It's important to note that not everyone who has these treatments will get AML.

• High doses of radiation: Exposure to very high levels of radiation, like from a nuclear accident, significantly raises the risk of AML. Normal levels of radiation exposure from things like X-rays are not thought to be a major risk factor.

• Exposure to harmful chemicals: Certain chemicals, such as benzene, a substance found in some industrial products, are linked to a higher chance of developing AML. This is why working in certain environments may raise the risk.

• Smoking: Smoking cigarettes exposes people to benzene and other dangerous chemicals, increasing their risk of AML. Quitting smoking is a crucial step in reducing this risk.

• Other blood disorders: If you have a blood disorder, like myelodysplasia, myelofibrosis, polycythemia vera, or thrombocythemia, you have a higher chance of developing AML. These disorders often involve abnormalities in the production or function of blood cells.

• Inherited genetic conditions: Some genetic conditions, such as Down syndrome, can make a person more susceptible to AML. These conditions affect how cells grow and divide.

• Family history: If a close relative, like a parent, sibling, or grandparent, has had a blood or bone marrow disorder, you may have a slightly higher risk of AML. This suggests a potential genetic link.

Important Note: Many people with AML don't have any of these known risk factors, and many people with risk factors never develop the disease. This means that while these factors increase the possibility of getting AML, they don't guarantee it.

Diagnosing Acute Myeloid Leukemia (AML)

Acute myeloid leukemia (AML) is a type of blood cancer. Doctors use several tests and procedures to diagnose AML. These tests help them understand the specific type of cancer and the best treatment plan.

Physical Exam: A doctor will first examine you for signs such as bruising, bleeding in the mouth or gums, infections, and swollen lymph nodes. These signs can sometimes suggest AML.

Blood Tests: A complete blood count (CBC) is a common blood test. A CBC measures the different types of blood cells. In AML, a CBC might show abnormal numbers of white blood cells, red blood cells, or platelets. Another blood test specifically looks for immature white blood cells called myeloblasts. These cells aren't usually found in the blood, but their presence in a blood sample can be a sign of AML.

Bone Marrow Tests: Bone marrow is the spongy tissue inside your bones that makes blood cells. To examine the bone marrow, a doctor might perform a bone marrow aspiration and/or biopsy.

• Aspiration: A thin needle is used to remove a small amount of the liquid part of the bone marrow. This is usually taken from the hipbone.
• Biopsy: This procedure removes a tiny piece of bone tissue, along with the marrow inside. Again, the hipbone is a common spot.

These samples are sent to a lab for detailed analysis. Lab tests might look for specific changes in the DNA of the bone marrow cells. These DNA changes are important for diagnosis and determining the best treatment approach.

Lumbar Puncture (Spinal Tap): If there's a concern that the leukemia has spread to the brain or spinal cord, a lumbar puncture might be necessary. This procedure involves inserting a needle into the lower spine to collect cerebrospinal fluid (the fluid that surrounds the brain and spinal cord). The fluid is then tested in a lab.

Imaging Tests: Imaging tests create pictures of the inside of your body. In AML cases, imaging might include:

• CT scans (Computed Tomography): These create detailed cross-sectional images.
• MRI scans (Magnetic Resonance Imaging): These also provide detailed images, particularly helpful for soft tissues.
• PET scans (Positron Emission Tomography): These scans can help identify if the cancer has spread to other parts of the body.

Further Testing for AML Subtypes: If diagnosed with AML, further lab tests are often needed to pinpoint the specific subtype. These tests look for genetic changes and other features that characterize 15 different AML subtypes. This detailed information is crucial for choosing the most effective treatment plan.

By combining these tests and procedures, doctors can accurately diagnose AML and create a personalized treatment strategy.