Acute Myelogenous Leukemia

What is leukemia?

Leukemia is cancer of the blood cells, usually the white blood cells.

What are the types of leukemia?
There are four main types of leukemia, which can be further divided into subtypes. When classifying the type of leukemia, the first steps are to determine if the cancer is:

1. Lymphocytic or myelogenous leukemia:
Cancer can occur in either the lymphoid or myeloid white blood cells.

When the cancer develops in the lymphocytes (lymphoid cells), it is called lymphocytic leukemia.

When the cancer develops in the granulocytes or monocytes (myeloid cells), it is called myelogenous leukemia.

2. Acute or chronic leukemia:
Leukemia is either acute or chronic.

Acute leukemia
The new or immature cancer cells, called blasts, remain very immature and cannot perform their functions. The blasts increase in number rapidly, and the disease progresses quickly.

Chronic leukemia
There are some blast cells present, but they are more mature and are able to perform some of their functions. The cells grow more slowly, and the number increases less quickly, so the disease progresses gradually.

Based on these findings, the leukemia is then classified into one of the four main types of leukemias: acute myelogenous leukemia (AML); chronic myelogenous leukemia (CML); acute lymphocytic leukemia (ALL); or chronic lymphocytic leukemia (CLL).

What is acute myelogenous leukemia?

Acute myelogenous leukemia (AML) is a cancer of the blood usually in which too many granulocytes, a type of white blood cell, are produced in the bone marrow.

Normally, bone marrow cells mature into several different types of blood cells. Acute myelogenous leukemia usually affects the young blood cells (called blasts) that normally develop into a type of white blood cell (called granulocytes). The main function of granulocytes is to destroy bacteria. The blasts, which do not mature and become too numerous, remain in the bone marrow and blood. Acute leukemia is a fast growing cancer that needs to be treated as soon as possible after it is diagnosed. Chromosome abnormalities (extra chromosomes and structural changes in the chromosome material) are present in the majority of AML patients.

According to the American Cancer Society, about 45,000 leukemia cases are expected in 2011. About 13,000 of these will be AML.

What are the symptoms of acute myelogenous leukemia?

The following are the most common symptoms of acute myelogenous leukemia. However, each individual may experience symptoms differently. Symptoms may include:

  • Anemia (too few red blood cells)
  • Bleeding
  • Bruising
  • Fever and recurring infections
  • Persistent weakness
  • Fatigue
  • Aches in bones and joints
  • Swollen gums, lymph nodes, liver, or spleen
  • Weight loss
  • Night sweats

The symptoms of acute myelogenous leukemia may resemble other blood disorders or medical problems. Always consult your doctor for a diagnosis.

How is acute myelogenous leukemia diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for acute myelogenous leukemia may include the following:

  • Blood tests and other evaluation procedures
  • Bone marrow aspiration and/or biopsy--a procedure that involves taking a small amount of bone marrow fluid (aspiration) and/or solid bone marrow tissue (called a core biopsy), usually from the hip bones, to be examined for the number, size, and maturity of blood cells and/or abnormal cells.
  • Spinal tap/lumbar puncture--a special needle is placed into the lower back, into the spinal canal. This is the area around the spinal cord. A small amount of cerebral spinal fluid (CSF) can be removed and sent for testing to determine if there are leukemia cells in the CSF or other problems. CSF is the fluid that bathes the brain and spinal cord.

Treatment for acute myelogenous leukemia

Specific treatment for acute myelogenous leukemia will be determined by your doctor based on:

  • Your age, overall health, and medical history
  • The subtype of AML
  • Extent of the disease
  • Your tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the disease
  • Your opinion or preference

Treatment may include:

  • Chemotherapy or other drug therapies
  • Radiation therapy
  • Bone marrow or peripheral stem cell transplantation