Acute Myeloid Leukemia Cancer from Diagnosis to Treatment
What is Acute Myeloid Leukemia?
Acute Myeloid Leukemia is a fast-growing cancer of the blood and bone marrow that starts in the myeloid cells - the cells that normally develop into red blood cells, white blood cells, and platelets.
In AML, the bone marrow produces abnormal immature cells | called myeloblasts | that do not mature properly. These leukemia cells build up and crowd out normal blood cells, leading to problems with anemia, infections, and bleeding.
AML is most common in adults, especially older adults, but it can also occur in children.
Acute Myeloid Leukemia is a fast-growing cancer of the blood and bone marrow that starts in the myeloid cells - the cells that normally develop into red blood cells, white blood cells, and platelets.
In AML, the bone marrow produces abnormal immature cells | called myeloblasts | that do not mature properly. These leukemia cells build up and crowd out normal blood cells, leading to problems with anemia, infections, and bleeding.
AML is most common in adults, especially older adults, but it can also occur in children.
1. Early Signs and Symptoms
• Fatigue and weakness
• Frequent infections or fevers
• Easy bruising or bleeding, nosebleeds, or bleeding gums
• Pale skin
• Shortness of breath
• Bone or joint pain
• Swollen gums
• Loss of appetite and weight loss
• Swelling in the liver, spleen, or lymph nodes
• Fatigue and weakness
• Frequent infections or fevers
• Easy bruising or bleeding, nosebleeds, or bleeding gums
• Pale skin
• Shortness of breath
• Bone or joint pain
• Swollen gums
• Loss of appetite and weight loss
• Swelling in the liver, spleen, or lymph nodes
2. Causes and Risk Factors
The exact cause of AML is often unknown, but risk factors include
• Previous chemotherapy or radiation therapy
• Exposure to benzene
• Genetic disorders
• Blood disorders such as myelodysplastic syndrome or myeloproliferative neoplasms
• Smoking
• Older age
The exact cause of AML is often unknown, but risk factors include
• Previous chemotherapy or radiation therapy
• Exposure to benzene
• Genetic disorders
• Blood disorders such as myelodysplastic syndrome or myeloproliferative neoplasms
• Smoking
• Older age
3. Diagnostic Procedure
Physical Examination
The doctor checks for anemia, bruising, enlarged spleen or liver, and other signs of leukemia.
Imaging Tests
Chest X-ray, CT scan, or MRI may be used to check organ involvement.
Bone Marrow Aspiration and Biopsy
Confirms diagnosis by identifying 20% or more myeloblasts in bone marrow.
The sample helps classify AML subtypes.
Blood Tests
Complete Blood Count:
Shows abnormal levels of white cells, red cells, and platelets.
Peripheral Blood Smear:
Reveals immature myeloblasts under a microscope.
Cytogenetic and Molecular Tests
Detects genetic mutations or chromosomal changes such as FLT3, NPM1, or IDH1/2.
Helps determine prognosis and targeted treatment options.
Lumbar Puncture | Spinal Tap
Done if symptoms suggest leukemia cells have spread to the central nervous system
Physical Examination
The doctor checks for anemia, bruising, enlarged spleen or liver, and other signs of leukemia.
Imaging Tests
Chest X-ray, CT scan, or MRI may be used to check organ involvement.
Bone Marrow Aspiration and Biopsy
Confirms diagnosis by identifying 20% or more myeloblasts in bone marrow.
The sample helps classify AML subtypes.
Blood Tests
Complete Blood Count:
Shows abnormal levels of white cells, red cells, and platelets.
Peripheral Blood Smear:
Reveals immature myeloblasts under a microscope.
Cytogenetic and Molecular Tests
Detects genetic mutations or chromosomal changes such as FLT3, NPM1, or IDH1/2.
Helps determine prognosis and targeted treatment options.
Lumbar Puncture | Spinal Tap
Done if symptoms suggest leukemia cells have spread to the central nervous system
4. Classification of ALL
ALL is classified based on the type of lymphocyte affected.
French-American-British | system
M0 to M7 subtypes based on cell maturity.
WHO
focuses on genetic and chromosomal abnormalities, which better guide treatment.
ALL is classified based on the type of lymphocyte affected.
French-American-British | system
M0 to M7 subtypes based on cell maturity.
WHO
focuses on genetic and chromosomal abnormalities, which better guide treatment.
5. Treatment Options
➛ Induction Therapy
Goal:
Achieve remission by destroying leukemia cells in the blood and bone marrow.
Common regimen: chemotherapy
Cytarabine for 7 days
Daunorubicin or Idarubicin for 3 days
Hospitalization is usually required due to low immunity and risk of infection.
➛ Consolidation | Post-Remission | Therapy
Goal:
Eliminate any remaining leukemia cells and prevent relapse.
Options include:
High-dose chemotherapy | Cytarabine
Stem cell transplant for patients at high risk of relapse or with poor prognostic mutations
➛ Maintenance Therapy
Lower-dose chemotherapy for 2-3 years to maintain remission.
Common drugs:
Methotrexate
6-mercaptopurine
Vincristine
Prednisone.
➛ Targeted Therapy
Midostaurin or Gilteritinib
for FLT3-mutated AML
Ivosidenib or Enasidenib
for IDH1/2 mutations
Venetoclax
blocks proteins that help leukemia cells survive, often combined with azacitidine in older patients
➛ Immunotherapy
Monoclonal antibodies and immune checkpoint inhibitors are under study for AML.
➛ Stem Cell Transplant
Replaces diseased bone marrow with healthy donor cells.
Used for patients with relapsed or high-risk AML after initial chemotherapy.
➛ Supportive Care
Blood transfusions, antibiotics, and growth factors to manage complications of low blood counts.
➛ Induction Therapy
Goal:
Achieve remission by destroying leukemia cells in the blood and bone marrow.
Common regimen: chemotherapy
Cytarabine for 7 days
Daunorubicin or Idarubicin for 3 days
Hospitalization is usually required due to low immunity and risk of infection.
➛ Consolidation | Post-Remission | Therapy
Goal:
Eliminate any remaining leukemia cells and prevent relapse.
Options include:
High-dose chemotherapy | Cytarabine
Stem cell transplant for patients at high risk of relapse or with poor prognostic mutations
➛ Maintenance Therapy
Lower-dose chemotherapy for 2-3 years to maintain remission.
Common drugs:
Methotrexate
6-mercaptopurine
Vincristine
Prednisone.
➛ Targeted Therapy
Midostaurin or Gilteritinib
for FLT3-mutated AML
Ivosidenib or Enasidenib
for IDH1/2 mutations
Venetoclax
blocks proteins that help leukemia cells survive, often combined with azacitidine in older patients
➛ Immunotherapy
Monoclonal antibodies and immune checkpoint inhibitors are under study for AML.
➛ Stem Cell Transplant
Replaces diseased bone marrow with healthy donor cells.
Used for patients with relapsed or high-risk AML after initial chemotherapy.
➛ Supportive Care
Blood transfusions, antibiotics, and growth factors to manage complications of low blood counts.
6. Follow-Up
➛ Regular bone marrow exams and blood tests are needed to monitor remission or relapse.
➛ Long-term follow-up includes managing side effects from chemotherapy and monitoring for secondary cancers.
➛ Regular bone marrow exams and blood tests are needed to monitor remission or relapse.
➛ Long-term follow-up includes managing side effects from chemotherapy and monitoring for secondary cancers.
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