What is Acute Myelogenous Leukemia?

Acute myelogenous leukemia (AML) is also known as acute myeloid leukemia, acute myeloblastic leukemia, acute granulocytic leukemia, and acute nonlymphocytic leukemia. AML has eight subtypes that are identified by examining the blast cells in the blood or bone marrow, and treatment may vary based on the subtype.

The origin of AML is damage to the DNA of developing myeloid cells of bone marrow. Leukemic cells are called myeloblast cells, or simply blast cells. As a result of this damage, these blast cells are unable to develop and fight infections. They rapidly crowd out normal white blood cells, red blood cells, and platelets.

Acute myelogenous leukemia is the most common type of acute leukemia. The risk of developing AML increases with age, with most cases being found in patients age 60 or older. Fewer than 10% of those diagnosed are children. Risk factors include Down syndrome and other uncommon genetic disorders, some types of chemotherapy, a high level of radiation exposure, smoking, exposure to large amounts of benzene, and other blood disorders. It is believed that most cases are not inherited.

The symptoms of acute myelogenous leukemia include fatigue, shortness of breath on exertion, pale skin, swollen or bleeding gums, slow-healing wounds, mild fever, bruising of unknown origin, bone and joint aches, weight loss, frequent infections, pinpoint red spots under the skin, prolonged bleeding from minor cuts, and frequent nosebleeds.

Diagnosis is made through blood and bone marrow tests. Bone marrow tests may include bone marrow aspiration and/or bone marrow biopsy. Bone marrow aspiration is performed to examine the cell type and identify certain abnormalities by looking at proteins on the cell's surface. This can be used for cytogenic analysis, a laboratory test that examines the chromosomes of blast cells. Bone marrow biopsy reveals chromosomal and genetic abnormalities as well as the extent of the disease in the marrow.

Treatment of acute myelogenous leukemia commences as soon as possible and is initiated with induction therapy, which kills the blast cells in an attempt to restore normal blood cells over time. The goal of induction therapy is to achieve remission. Following induction therapy, consolidation therapy aims to destroy AML cells not found in common blood or bone marrow tests. Treatment may include chemotherapy with autologous or allogenic stem cell transplant. Autologous stem cells are stem cells that are supplied by the patient, whereas allogenic stem cells are typically provided by a close family member.