Acute Myeloid Leukemia (AML) in Adults

Acute Myeloid Leukemia (AML) in Adults

Acute Myeloid Leukemia (AML) is a type of cancer that affects the blood cells and bone marrow. In AML, the bone marrow produces abnormal cells that do not mature properly, leading to a buildup of immature blood cells called myeloblasts. These abnormal cells can crowd out the normal blood cells in the bone marrow, leading to a range of symptoms.

AML is more common in older adults, with the average age of diagnosis being around 68 years old. There are several subtypes of AML, and the specific subtype can affect the outlook and treatment options.

Causes and Risk Factors

Acute Myeloid Leukemia (AML) is a type of cancer that affects the blood and bone marrow. The exact causes of AML are not well understood, but several factors have been identified as potential risk factors for developing the disease.

1. Age – AML is more common in adults, especially those over the age of 60.
2. Exposure to radiation and chemicals – Exposure to high levels of radiation and certain chemicals, such as benzene, can increase the risk of developing AML.
3. Previous chemotherapy or radiation treatment – Individuals who have undergone chemotherapy or radiation therapy for previous cancer have an increased risk of developing AML later in life.
4. Genetic disorders – Certain genetic disorders, such as Down syndrome, Fanconi anemia, and Bloom syndrome, can increase the risk of developing AML.

Acute Myeloid Leukemia (AML) in Adults

5. Smoking – Smoking has been linked to an increased risk of developing AML.

6. Family history – AML can run in families, although this is relatively rare.

7. Immune system deficiencies – Individuals with weakened immune systems, such as those with HIV/AIDS or who have undergone organ transplants, are at an increased risk of developing AML.

8. Gender– Men have a slightly higher risk of developing AML than women.

Having one or more of these risk factors does not necessarily mean that a person will develop AML. Many people with AML have no known risk factors, and not everyone with risk factors will develop the disease.

Signs and Symptoms

The signs and symptoms of Acute Myeloid Leukemia (AML) can vary depending on the stage and severity of the disease, but they generally develop quickly and become more severe over time. Here are some common signs and symptoms of AML –

1. Fatigue and weakness – AML can cause a general feeling of tiredness and weakness, even with rest.
2. Shortness of breath – AML can cause a decrease in the number of healthy red blood cells, which can lead to shortness of breath and difficulty breathing.
3. Unexplained weight loss – AML can cause weight loss even if a person is eating normally.
4. Easy bruising and bleeding – AML can cause a decrease in the number of healthy blood platelets, which can lead to easy bruising and bleeding, such as nosebleeds and bleeding gums.
5. Frequent infections – AML can cause a decrease in the number of healthy white blood cells, which can lead to an increased risk of infections.
6. Bone pain – AML can cause pain in the bones, especially in the back, hips, and ribs.
7. Enlarged spleen – AML can cause the spleen to enlarge, leading to discomfort or pain in the upper left part of the abdomen.
8. Fever – AML can cause a persistent low-grade fever or a high fever that comes and goes.

If a person experiences any of these symptoms, they should see a doctor for a diagnosis and treatment. Early detection and treatment of AML can improve the chances of a successful outcome.

Diagnosis and Tests

Acute Myeloid Leukemia (AML) can be diagnosed through a series of tests and exams. Here are some common methods used to diagnose AML –

1. Blood tests – Blood tests can be used to look for abnormal levels of white blood cells, red blood cells, and platelets. AML can cause abnormal blood cell counts.
2. Bone marrow biopsy – A bone marrow biopsy involves taking a sample of bone marrow from the hipbone or breastbone. The sample is examined under a microscope to look for leukemia cells.
3. Imaging tests – Imaging tests, such as X-rays, CT scans, or MRI scans, can be used to look for signs of leukemia in the body.
4. Cytogenetic analysis – Cytogenetic analysis involves examining the chromosomes of leukemia cells. This test can identify specific genetic changes that are associated with AML.
5. Flow cytometry – Flow cytometry is a type of blood test that can be used to look for specific proteins on the surface of leukemia cells. This test can help determine the subtype of AML.
6. Immunohistochemistry – Immunohistochemistry is a type of test that can be used to identify specific proteins in bone marrow or blood samples.

If AML is diagnosed, additional tests may be done to determine the extent of the disease and to help develop a treatment plan. It is important to work with a healthcare professional who specializes in the treatment of leukemia.

Treatments

The treatment for Acute Myeloid Leukemia (AML) in adults depends on several factors, including the subtype of AML, the age and overall health of the patient, and the extent of the disease. Here are some common treatments for AML –

1. Chemotherapy – Chemotherapy is the most common treatment for AML. It involves the use of drugs to kill cancer cells. Chemotherapy may be given as a pill or injection.
2. Stem cell transplant – Stem cell transplant also called bone marrow transplant, involves replacing diseased bone marrow with healthy bone marrow from a donor. This is usually reserved for younger patients with more aggressive disease.
3. Targeted therapy – Targeted therapy drugs are designed to target specific proteins in cancer cells. These drugs may be used in combination with chemotherapy.
4. Radiation therapy – Radiation therapy involves the use of high-energy radiation to kill cancer cells. It may be used in certain situations, such as when leukemia cells have spread to the brain.

Treatment for AML is typically done in stages, with initial treatment aimed at inducing remission. Maintenance treatment may then be given to prevent a relapse. It is important to work with a healthcare professional who specializes in the treatment of leukemia to determine the best course of action for an individual case.

Outlook

Treatment for AML typically involves chemotherapy, and in some cases, a stem cell transplant may be necessary. The response to treatment can vary widely depending on the patient and the specific type of AML they have.

For younger patients (under 60 years old) with AML who receive aggressive treatment, the outlook can be relatively good, with a remission rate of 60-80%. However, older patients and those with other health problems may have a poorer prognosis, with a lower likelihood of achieving remission.

Recent advancements in targeted therapies and immunotherapies hold promise for improving outcomes for patients with AML. These new treatments are being studied in clinical trials, and some have been approved by the FDA for use in certain patients with AML.

Overall, the outlook for AML is improving as new treatments are developed and refined. However, it is important to work closely with a healthcare provider to develop an individualized treatment plan and understand the specific risks and benefits of different treatment options.