A.M.

L
Acute Myeloid Leukemia
AML
 About 12,330 are expected to be diagnosed
with AML this year
 The chance to get AML increases with age
 However children and adults of any age can

develop AML
 About 1 in 5 children with leukemia have AML
 AML is more common in men than in women
 Is rare under the age of 40
 Most of the time a doctor cannot tell what

caused AML
AML causes and risk factors
 Itstarts with a change to a single cell in the
bone marrow
 With AML the leukemic cells are often

referred to as blast cells

 Risk Factors associated with AML are:
 Some types of Chemo
 Radiation therapy used to treat other cancers
 Tobacco smoke
 Exposure to large amounts of benzene
 You cannot catch AML from someone else
Diagnosis
 Blood and bone marrow tests are done to
diagnosis AML
 Bone marrow aspiration
 Bone marrow biopsy
 Bone marrow aspiration shows the cell type
and the abnormalities by looking at proteins
on the cell surface.
 A bone marrow biopsy shows chromosome
and gene abnormalities and how much
disease is in the marrow
Diagnosis Continued
 Cytogenetic analysis is a lab test to examine
the chromosomes of the leukemic blast cells.
 Some changes to chromosomes give doctors

information about how to treat their patients

with AML
Subtypes of AML
Most patients with AML have 1 of
8 different subtypes.

Designation Cell Subtype

M0 Myeloblastic , on special analysis
M1 Myeloblastic , without maturation
M2 Myeloblastic, with maturation
M3 Promyeloctic
M4 Myelomonocytic
M5 Monocytic
M6 Erythroleukemia
M7 Megakaryocytic
Subtypes (Cont.)
 Doctors look at the AML cells within the
patients marrow or blood to identify the
subtype.

 Treatment varies by subtype

- Acute promyelocytic leukemia & Acute
monocytic leukemia are subtypes that need
different treatment
Signs & Symptoms
 Some signs and symptoms of AML are common to
may illnesses, changes that a person with AML may
have are:
 Tiredness or no energy
 Shortness of breath during physical activity
 Pale skin
 Swollen gums
 Slow healing of cuts
 Pinhead sized red dots under the skin
 Prolonged bleeding from minor cuts
 Mild fever
 Bruises with no clear cause
 Aches in bones or knees, hips or shoulder
Treatment
 Patientswith AML need to start chemotherapy
right away.
 There are two parts to treatment
 Induction therapy
 Consolidation therapy
 Induction therapy is aimed at killing as many
AML cells as possible and get the blood cells
back to normal over time
 When the aim of induction therapy is reached

its called remission

Treatment Continued
 More treatment is usually needed even if the
patient is in remission
 The second part is called consolidation

therapy
 This type of therapy is needed because some

AML cells remain that are not found in

common blood and marrow test
 Consolidation therapy is also done in a

hospital
Treatment Continued
 Consolidation therapy
Drugs used for AML
may include
chemotherapy with or  Neupogen, Neulasta,
with out allogenic stem and Leukine are drugs
cell transplant or to increase white cell
autologous stem cell count
transplant  Zarnesta, Velcade,
cyclosporine A,
Genasense, and
Dacogen are some
drugs under study for
future AML use
Treatment in Children
 Induction therapy for children starts with two
or three drugs
 Stronger treatment is needed after a child is

in remission, this is called intensive

consolidation therapy
 Consolidation therapy in children includes a

number of chemotherapies
 About 4 out of 5 children go into remission
Treatment in Children Continued
 AMLtreatment is less likely to bring about
remission or cure when children:
 Have acute myelogenous leukemia with a very high white
cell count
 Are younger than 1 year of age
 Have certain chromosomes in their AML cells that are not
normal
 Allogeneicstem cell transplant may be used
when a child is not doing well or who has a
relapse after a high-dose of chemotherapy
Treating AML Subtypes
 Acute Promyelocytic Leukemia is the most
curable form of AML
 People with this form of AML are treated with

a substance that comes from vitamin A called

all-trans retinoic acid (ATRA)
 ATRA is given along with chemotherapy
 Its often successful in bringing this type of

AML into remission

Treating AML Subtypes Continued
 Another treatment is arsenic trioxide (ATO)
 It may be given to patients who’s leukemia has

returned or cannot be brought under control with

chemo or ATRA
 Acute monocytic leukemia is where cells are more

likely to invade the lining of the spinal cord or

brain
 The patient receives chemotherapy

right into the spinal canal

Treating AML Subtypes Continued
 A needle is placed into the spinal canal this
procedure is called a spinal tap
 Spinal fluid is removed and chemotherapy is

injected into the spinal canal

 Some radiation may be used to treat a large

mass of cells
Side Effects
o Not all patients have side effects
o Chemo and radiation therapy often affect a
person’s blood count (Anemia)
o They usually have a drop in the number of
platelets
o A drop in white cells may lead to infection
o Patients with infection may also have
coughing, sore throat, pain when urinating,
or frequent loose bowel movements
Side Effects Continued
o Other Side effects may include:
• Mouth sores
• Rashes
• Dry mouth
• Diarrhea
• Constipation
• Hair loss
• Vomiting
• Change in the way food tastes
Prognosis
 When the signs and symptoms go away it is
called remission
 Remission occurs in most patients
 Younger patients tend to do better than those

who develop the disease at an older age

 If the cancer dose not come back with in 5

years the patient is considered permanently

cured
 Most times the cancer returns with in 2 years
Prognosis continued
 Chance of recovery and treatment options
depend on:
 The age of the patient
 The subtype of AML
 Whether the patient received chemo in the past to treat a
different cancer
 Whether there is a history of a blood disorder such as
myelodysplastic syndrome
 Whether the cancer has spread to the central nervous
system
 Whether the cancer has been treated before or recurred
 It is important the AML be treated right away
References

 National Cancer Institute- www.cancer.gov

 The Leukemia & Lymphoma Society-
www.leukemia-lymphoma.org
 NationalMarrow Donor Program-
www.marrow.org
 Medline Plus- www.nlm.nih.gov