Leukemia (Acute Myelocytic)

Acute Myelocytic Leukemia

What is acute myeloid leukemia? — Acute myeloid leukemia, called "AML," is a type of blood cancer. AML is usually fast-growing and needs to be treated quickly.
Blood is made up of different types of cells. These cells are made in the center of your bones, in a part called the bone marrow. When people have AML, their bone marrow makes abnormal blood cells instead of normal blood cells. These abnormal blood cells grow out of control, get into the blood, and travel around the body. Sometimes, these cells collect in certain parts of the body.
When the bone marrow makes abnormal blood cells, it does not make the normal blood cells a person's body needs. This can cause symptoms.
What are the symptoms of AML? — The most common symptoms of AML include:
Feeling very tired and weak
Bleeding more easily than normal
Getting sick from infections more easily than normal
Is there a test for AML? — Yes. Your doctor or nurse will talk with you and do an exam. They will also do:
Blood tests
Bone marrow biopsy – A doctor will take a very small sample of the bone marrow. Then another doctor will look at the cells under a microscope to see if abnormal (cancer) cells are present.
There are different types of AML. The test results can show which type you have. The right treatment for you will depend a lot on your age and the type of AML you have.
How is AML treated? — Treatment for AML usually includes 2 parts.
The first part of treatment is called "induction of remission" and lasts about 4 weeks. During this part, people stay in the hospital and get chemotherapy. Chemotherapy is the medical term for medicines that kill cancer cells or stop them from growing.
For people who are not well enough to get this much chemotherapy, there are other treatments. But they are generally not as effective.
Many people are in "remission" after the chemotherapy. This means that doctors do not see any abnormal blood cells in the blood or bone marrow. But even though doctors do not see any abnormal cells, there are still abnormal cells in the body. To kill these cells and prevent the AML from returning, people need more treatment.
The second part of treatment is called "post-remission therapy." During this time, people can have 1 or more of the following treatments:
More chemotherapy – People might need to stay in the hospital for a few days each month to get chemotherapy. This treatment can last 3 or 4 months.
Bone marrow transplant (also called "stem cell transplant") – This treatment replaces cells in the bone marrow that are killed by chemotherapy or radiation. These "donor" cells can come from different places, including:
•People who are related to you, and whose blood matches yours
•People who are not related to you, but whose blood matches yours
•Blood (that matches yours) from a newborn baby's umbilical cord
One type of AML, called "acute promyelocytic leukemia" or "APL," is treated differently from other types. People with APL might get other types of medicine, either with or without chemotherapy.
What happens after treatment? — After treatment, your doctor will check you every so often to see if the cancer comes back. Regular follow-ups include talking with your doctor, exams, and blood tests. Sometimes, your doctor will also do a bone marrow biopsy.
What happens if the AML comes back? — If the AML comes back, you might have more chemotherapy, radiation, or bone marrow transplantation.
What else should I do? — It's important to follow all your doctor's instructions about visits and tests. It's also important to talk to your doctor about any side effects or problems you have during treatment.
Getting treated for AML involves making many choices, such as what treatment to have.
Always let your doctors and nurses know how you feel about a treatment. Any time you are offered a treatment, ask:
What are the benefits of this treatment? Is it likely to help me live longer? Will it reduce or prevent symptoms?
What are the downsides to this treatment?
Are there other options besides this treatment?
What happens if I do not have this treatment?
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 15790 Version 14.0
Release: 28.2.2 - C28.105
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