Acute Myelogenous Leukemia

________________________________________________________________________

KEY POINTS

• Acute myelogenous leukemia (AML) is a cancer of the blood and bone marrow.
• AML is usually treated with chemotherapy or with a stem cell transplant.
• You will have regular blood tests and follow-up visits with your healthcare provider during and after treatment.

________________________________________________________________________

What is acute myelogenous leukemia?

Acute myelogenous leukemia (AML) is a cancer of the blood and bone marrow. AML affects bone marrow stem cells that produce white blood cells, red blood cells, and platelets. The cancer causes a build-up of abnormal white blood cells called myeloblasts in the bone marrow. The cancer can also prevent red blood cells and platelets from forming. The abnormal cells can affect the other organs in your body.

Other names for this type of leukemia are acute myeloid leukemia, acute myeloblastic leukemia, and acute granulocytic leukemia.

It is important to diagnose and treat leukemia as soon as possible. The main goals of treatment are to kill the cancer cells and prevent the cancer from spreading.

Ask your healthcare provider what you can expect with the type of cancer that you have.

What is the cause?

AML starts in the bone marrow. Marrow is the soft, fatty tissue inside hard bone. The marrow is where blood cells are formed.

• White blood cells help fight off infection.
• Red blood cells carry oxygen and nutrients to your body.
• Platelets help your blood clot.

In AML, the abnormal cells that form in the bone marrow crowd out normal blood cells and move into the bloodstream.

• The abnormal white cells cannot fight infections.
• Fewer red blood cells make you tired and weak.
• Fewer platelets cause you to bruise or bleed easily.

The cancer can also spread to the other organs in your body.

The exact cause of AML may not be known, but your risk of AML is greater if:

• You are a male
• You smoke, especially after age 60
• You have had chemotherapy or radiation therapy in the past
• You have had treatment for acute lymphoblastic leukemia (ALL) in the past
• You have an inherited disorder such as Down syndrome
• You have been exposed to a lot of radiation, like from a nuclear accident
• You have been exposed to certain chemicals such as benzene from cigarette smoke, gasoline, or some oil-based products
• You have a history of some types of blood diseases such as polycythemia vera, primary myelofibrosis, essential thrombocythemia, or myelodysplastic syndrome

What are the symptoms?

You may have no symptoms or just mild flu-like symptoms at first. The symptoms slowly get worse. Signs and symptoms may include:

• Feeling very tired or weak
• Feeling short of breath
• Fever with or without an infection
• Bruising or bleeding easily
• Pale skin
• Tiny red dots under the skin (petechiae) caused by bleeding
• Bone or joint pain
• Weight loss

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Your healthcare provider may discover the disease during a routine blood test. You may have a bone marrow biopsy, which uses a needle passed through the skin to take a small sample of tissue for testing, usually from the back pelvic bone.

You may have more tests to help your healthcare provider get more information about your AML type:

• Lumbar puncture
• CT scan

How is it treated?

You and your healthcare provider will discuss possible treatments. You may also talk with a cancer specialist. Some things to think about when making treatment decisions are:

• Your age
• Your overall health
• The type of leukemia you have
• Whether you have had treatment for AML in the past

Possible treatments are:

• Chemotherapy (anticancer drugs), which uses medicine to kill cancer cells
• Stem cell transplant using your own cells or cells from a donor
• Biological therapy or targeted therapy, which uses medicine designed to help your immune system fight the cancer or block the growth of cancer cells

Your treatment will also include:

• Preventing infections
• Controlling pain
• Preventing and controlling the side effects from treatments. Side effects may be different for each person based on the treatment you receive.
• Helping you manage your life with cancer

Often, more than 1 treatment is used.

Ask your healthcare provider about clinical trials that might be available to you. Clinical trials are research studies to find effective cancer treatments. It is always your choice whether you take part in one or not.

With treatment, many people with AML go into remission. This means that your blood cell counts are normal, and no signs of AML are found in your body. AML can come back, so you may continue to have treatment. You will need to see your healthcare provider for regular checkups during and after treatment.

How can I take care of myself?

If you have been diagnosed with AML:

• Talk about your cancer and treatment options with your healthcare provider. Make sure you understand your choices.
• Follow the full course of treatment prescribed by your healthcare provider.
• Ask your healthcare provider:
  • How and when you will get your test results
  • If there are activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

Other things that may help include:

• Eat a healthy diet and get regular exercise as recommended by your healthcare provider.
• Get plenty of rest.
• Try to reduce stress and take time for activities that you enjoy. Talk with your family and your healthcare providers about your concerns. Ask your healthcare provider any questions you have about the disease, treatments, side effects of the treatments, sexual activity, support groups, and anything else that concerns you.
• If you smoke, try to quit.
• Ask your provider if you need to avoid drinking alcohol. It may interfere with medicines you are taking. Alcohol can also make it harder for white blood cells to fight infections.
• Tell your provider if your treatment causes discomfort. Usually there are ways to help you be more comfortable.

For more information, contact:

• National Cancer Institute
  800-422-6237
  https://www.cancer.gov/