What Is Acute Myeloid Leukemia?
Leukemia is a cancer in which many of the white blood cells produced in the bone marrow develop abnormally, and are unable to perform their task of fighting infection. Acute myeloid leukemia (AML), which involves a particular kind of white blood cell known as a myelocyte, comprises 32 percent of all adult cases, and is the second most common type of leukemia in children.
Signs and Symptoms
Sean Fischer, M.D., medical oncologist and hematologist at Providence Saint John’s Health Center in Santa Monica, California, notes, “This type of cancer happens very early in the blood cell production cycle. The ‘acute’ designation of AML means that it usually comes on suddenly and causes significant symptoms, creating a life-threatening situation,” whereas chronic leukemias may take more time to develop and have milder symptoms.
The most common signs and symptoms of AML are fever, fatigue, easy bruising, general weakness, anemia, and a low blood cell count. Because your immune system is taking such a hit from the abnormal cells—basically, it’s not getting the replenishment of white blood cells that it needs to function properly—you may also experience frequent infections and colds.
The bleeding and bruising is usually related to poorly functioning platelets, the type of blood cells that form blood clots and stop bleeding.
There are several subtypes of AML, Dr. Fischer says, which are diagnosed based on factors like cancer cell maturity and genetic information.
Although both children and adults can develop AML, it’s most common in adults, particularly those who are older, says Jack Jacoub, M.D., medical oncologist and medical director of MemorialCare Cancer Institute at Orange Coast Medical Center in Fountain Valley, California.
Men tend to develop AML more than women, and it’s also more likely in smokers, especially those over age 60. Other risk factors include previous chemotherapy or radiation treatments, history of childhood leukemia, previous diagnosis of a blood disorder, and potential exposure to certain chemicals like benzene.
An AML diagnosis is made first through a blood test that includes information on the number of white blood cells, platelets, and red blood cells you have, as well as the amount of hemoglobin—a protein that carries oxygen through your body—in your red blood cells.
If leukemia is suspected, you’ll go through a bone marrow aspiration and biopsy, where a small amount of your bone marrow is removed and examined. If you’re diagnosed with AML, tests will be suggested for discovering whether the cancer cells have spread to other areas. The most common places for AML to spread are the spinal cord, spleen, brain, and liver, according to Dr. Jacoub.
Because it’s a life-threatening form of cancer, AML should be treated immediately, usually through repetitive cycles of chemotherapy, Dr. Jacoub says. Treatment will often depend on the age and health of the patient, he adds.
“Younger people can tolerate a lot of therapy like a bone marrow transplant,” he says. “Older adults sometimes don’t have that level of tolerance, they don’t have the bone marrow reserves you’d need for a successful transplant.”
But that doesn’t mean older adults don’t have options. There are targeted therapies and clinical trials, and every treatment is tailored according to patient need, he adds.