The acute myeloid leukemia (AML) is a type of blood cancer that attacks the bone marrow and the blood cells. If not treated promptly, AML can be life-threatening. It is an aggressive and fast-growing disease. This blog post will explore its causes, symptoms, diagnosis, treatment, and prevention.
The exact cause of AML is not known, but some factors may increase the risk of developing it. These include:
Age: AML is more common in older adults than in younger people. The risk increases with age.
Sex: Men are more likely to develop AML than women.
Previous cancer treatment: People who have had certain types of chemotherapy or radiation therapy for other cancers may have a higher risk of developing AML.
Exposure to radiation: People who have been exposed to very high levels of radiation, such as survivors of a nuclear reactor accident or workers in nuclear power plants, may have an increased risk of developing AML.
Exposure to chemicals: Some chemicals, such as benzene, which is found in gasoline, tobacco smoke, and some industrial products, may increase the risk of developing AML. Other chemicals that may be linked to AML include arsenic, chromium hexavalent compounds (CrHVCs), and vinyl chloride monomer (VCM).
Genetic mutations: Some people may inherit genetic mutations that make them more prone to developing AML. For example, some people have a mutation in the gene TP53 that protects against cancer.
The symptoms of AML may vary depending on the type and stage of the disease. Some common symptoms include:
Fever
Bone pain
Fatigue
Shortness of breath
Pale skin
Frequent infections
Easy bruising or bleeding
Unusual bleeding, such as frequent nosebleeds and bleeding from the gums
Dizziness
Headaches
Loss of appetite
Unexplained weight loss
Some people with AML may also experience:
Swollen lymph nodes
Weakness
Tiny red spots on the skin (petechiae)
Wounds or sores that don’t heal
Your doctor will ask you about your medical history, family history, exposure to chemicals or radiation, and any symptoms you have been experiencing in order to diagnose AML. A physical examination will also be conducted by your doctor to look for signs of infection or organ damage.
Next, your doctor will order some blood tests to check your blood count and look for abnormal white blood cells. If you have a high number of abnormal white blood cells or a low number of normal white blood cells, it may indicate leukemia. Your doctor may also order other tests to check your liver function, kidney function, electrolytes, and coagulation factors.
Bone marrow biopsy is the most definitive test for diagnosing AML. A thin needle is used to take a small amount of your bone marrow from your hip bone. A haematologist (specializing in treating blood conditions) examines the bone marrow sample under a microscope. Based on certain genetic characteristics, the haematologist will determine the type of AML you have based on the presence of cancerous cells in your bone marrow sample.
Other tests that may be done to diagnose AML include:
Genetic testing: This can be done on blood or bone marrow samples to find out what type of mutations are present in your leukemia cells. This can help doctors choose the most appropriate treatment for you.
Chest X-ray: This can be done to check if there are any problems with your heart or lungs.
Lumbar puncture: This can be done in rare cases where there is a risk that AML has spread to your nervous system. This involves taking a sample of the fluid that surrounds your brain and spinal cord (cerebrospinal fluid) using a needle.
The treatment options for AML depend on several factors, including your age, health status, type and subtype of leukemia, genetic profile, response to previous treatments, and personal preferences. The main goal of treatment is to cure the disease or control it until it can be cured by other means.
The main types of treatment for AML are:
Drugs are used in chemotherapy to kill cancer cells throughout your body. Chemotherapy can be given orally (by mouth), intravenously (through a vein), intramuscularly (into a muscle), intrathecally (into your spinal fluid), or topically (on your skin). There are many different ways to administer chemotherapy. It can be given alone or in combination with other medications.
In addition to nausea, vomiting, hair loss, fatigue, low blood counts, infections, bleeding, and nerve damage, chemotherapy may also cause side effects such as nausea, vomiting, hair loss, fatigue, low blood counts, infections, bleeding, and nerve damage.
Some common chemotherapy drugs used for AML are:
Cytarabine works by interfering with the DNA of cancer cells and preventing them from dividing. It is often given along with other drugs to treat AML that has returned after previous treatment.
The drug daunorubicin belongs to the anthracycline class, which works by damaging the DNA of cancer cells and killing them. It is often given in combination with other drugs to treat AML that has not responded well to previous treatment or that has certain genetic characteristics.
Midostaurin: This drug belongs to a class of drugs called tyrosine kinase inhibitors (TKIs), which work by blocking the signals that allow cancer cells to grow and survive. When AML has certain genetic characteristics or mutations, it is often given in combination with other drugs.
The drug Arsenic trioxide interferes with the DNA of cancer cells, causing them to die. It is often used to treat AML that has recurred after previous treatment or that hasn't responded well to other therapies.
In AML that has certain genetic features or mutations, all-trans retinoic acid stimulates the growth and differentiation of normal blood cells, and prevents abnormal blood cell formation.
The purpose of a stem cell transplant is to replace damaged bone marrow with healthy stem cells, either from a donor or from your own body. A stem cell is an immature blood cell that can develop into different types of blood cells. Your body contains these cells in certain tissues, including bone marrow, umbilical cord blood, and placenta.
Stem cell transplant can be done using two types of sources:
An autologous stem cell transplant involves using your own stem cells obtained from your bone marrow before you begin treatment. You receive high doses of chemotherapy or radiation therapy first to destroy your bone marrow and create room for your new stem cells. A vein in your chest is used to receive the stem cells.
Transplanting stem cells from another person who matches your tissue type (HLA) is an allogeneic stem cell transplant. The stem cells are delivered through a vein in your chest after high doses of chemotherapy or radiation therapy destroy the bone marrow and make room for the new stem cells.
Stem cell transplant can cause serious complications such as graft-versus-host disease (GVHD), infection, bleeding, organ damage, and death. The risk of these complications depends on several factors, such as:
The source of your stem cells
The type and dose of chemotherapy or radiation therapy you receive before transplant
Your age
Your overall health
Your immune system
Stem cell transplant can also cause long-term side effects such as infertility, increased risk of infections, heart problems, lung problems, diabetes, thyroid problems, nerve damage, and secondary cancers.
The purpose of radiation therapy is to destroy cancer cells in specific areas of your body using high-energy rays or particles. Radiation therapy may be given externally (from a machine outside your body) or internally (from radioactive materials placed inside your body).
To kill any remaining cancer cells after chemotherapy or stem cell transplant, radiation therapy can be used alone or in combination with other treatments for AML.
Side effects of radiation therapy include skin irritation, redness, swelling, itching, peeling, blistering, hair loss, fatigue, nausea, vomiting, diarrhea, mouth sores, dry mouth, difficulty swallowing, and changes in taste.
The dose and duration of radiation therapy depend on the type and stage of AML you have. The goal of radiation therapy is to shrink the tumor and relieve symptoms.
Supportive care is any treatment that helps you cope with the side effects of other treatments or with the disease itself. Supportive care may include:
Palliative care is a type of treatment that focuses on improving your quality of life and relieving your symptoms. It can include pain management, emotional support, spiritual guidance, social work, counseling, and hospice care.
A blood transfusion replaces your blood with healthy blood from a donor. Anemia (low red blood cell count), bleeding problems (low platelet count), infections (low white blood cell count), and shock (low blood pressure) can be treated with blood transfusions.
Antibiotics: These are drugs that kill bacteria that may cause infections. Antibiotics are usually given through a vein (intravenously) or by mouth.
Antifungals: These are drugs that kill fungi that may cause infections. Antifungals are usually given through a vein (intravenously) or by mouth.
Antivirals: These are drugs that kill viruses that may cause infections. Antivirals are usually given through a vein (intravenously) or by mouth.
Immunoglobulins: These are proteins made by the immune system that help fight infections. Immunoglobulins are usually given through a vein (intravenously) or by injection.
Corticosteroids: These are drugs that reduce inflammation and suppress the immune system. Corticosteroids can help prevent or treat severe infections and allergic reactions caused by other treatments.
Radiation therapy can cause itching and swelling due to the release of histamine, a chemical that causes allergic reactions. Antihistamines can help relieve these symptoms.
The use of nutritional supplements can help replenish nutrients lost during cancer treatment. Nutritional supplements include vitamins, minerals, protein shakes, appetite stimulants, laxatives, and enzymes.
There is no sure way to prevent acute myeloid leukemia (AML), but some steps may help reduce your risk of developing it. These include:
Avoid smoking: Smoking is the most significant controllable risk factor for AML. Quitting smoking can lower your risk of AML and many other health problems.
The risk of AML may be increased by chemicals, such as benzene, found in gasoline, tobacco smoke, and industrial products. Arsenic, chromium hexavalent compounds (CrHVCs), and vinyl chloride monomer (VCM) may also be linked to AML. You can reduce your exposure to these chemicals by avoiding or limiting your contact with them at work or in your environment.
It is important to avoid radiation: Some types of radiation, such as X-rays and gamma rays, may increase the risk of AML. If you work with radioactive materials or undergo medical procedures that involve radiation, you can reduce your radiation exposure by using shielding devices, wearing protective clothing, and following safety guidelines.
AML can be caused or exacerbated by certain infections. You should talk to your doctor about which vaccines you need and when to get them if you have hepatitis B virus (HBV), human papillomavirus (HPV), influenza virus (flu), or pneumococcal bacteria.
You can maintain a healthy weight and boost your immune system by eating a balanced diet consisting of fruits, vegetables, whole grains, lean proteins, and healthy fats. The intake of alcohol, salt, sugar, and processed foods that may cause inflammation or damage to your DNA should also be limited.
You should consult your doctor if you have any questions or concerns regarding AML or its prevention. However, these steps are not guaranteed to prevent AML, but they may improve your overall health and well-being.
