Acute myeloid leukaemia
What is AML?
Acute myeloid leukaemia (AML) is a type of cancer that affects immature blood cells on the myeloid line. AML causes an overproduction of abnormal blast cells (immature white cells) which crowd bone marrow and prevent it from making normal blood cells. Because the bone marrow cannot function properly, it cannot produce adequate numbers of red cells, normal white cells and platelets.
This makes people with AML more susceptible to anaemia, recurrent infections, bruising and bleeding easily. The abnormal blast cells (leukaemic blasts) eventually spill out into the blood stream and can accumulate in various organs including the spleen and liver.
Because AML develops quickly patients usually report feeling unwell for only a short period of time before they are diagnosed.
The most common symptoms include:
- Anaemia, tiredness, fatigue, weakness and dizziness
- Increased bleeding or bruising
- Frequent or repeated infections
- Bleeding gums or blood in urine or after a bowel motion
The exact cause of AML is unknown but there are certain risk factors that may put some people at a higher risk of developing this disease. These include:
- People who have been exposed to large doses of radiation
- Very rarely an abnormal gene factor can be passed down from one generation to the next. Some congenital disorders are associated with the development of AML. These include including Down syndrome, Bloom syndrome and Fanconi anaemia.
- Chemicals including benzene, and exposure to chemotherapy drugs
- About 20 percent of AML cases are linked to smoking
- Pre-existing blood disorders
AML is usually identified by examining under a microscope a blood sample, taken either at the hospital or a GP’s surgery.
Most people with AML have a low red cell count, low haemoglobin level and a low platelet count. Many of the white blood cells may be abnormal leukaemic blast cells. The presence of leukaemic blast cells suggests the presence of AML. A diagnosis will need to be confirmed by examining the cells in your bone marrow.
A bone marrow examination involves taking a sample of bone marrow from the hip bone or from the sternum (breast bone) and sending it to be examined. AML is confirmed by the presence of an excessive number of blast cells in the bone marrow. In healthy adults the bone marrow contains less than five percent of blast cells but this can increase between 20 – 96 per cent in people who have AML.
The initial treatment for a newly-diagnosed patient with AML is chemotherapy, or a stem cell or bone marrow transplant.
Following treatment, most patients generally recover and go on to display normal blood marrow appearances, achieving a complete remission. However, sometimes the disease can reoccur (relapse) so patients are often given additional treatment to try and reduce the risk of this and turn remission into a complete cure. These subsequent doses of chemotherapy are referred to as ‘consolidation’ or ‘intensification’ chemotherapy and are aimed at stopping the return of the disease.
For more information visit our Treatment page