Alternative Names acute non-lymphocytic leukaemia, AML
Definition Acute myeloid leukaemia (AML) is a kind of cancer that occurs in a specialised white blood cell called a myelocyte. The cancerous change occurs in the bone marrow, where blood cells are made. This change causes many cancerous myelocytes to grow and take over the bone marrow. These cancerous cells also travel throughout the body, a process known as metastasis. They then interfere with the normal function of many parts of the body.
What is going on in the body? When the cancerous cells begin to grow in the bone marrow, normal bloods cells are destroyed or crowded out. These normal blood cells include platelets (used in blood clotting), red blood cells (which carry oxygen), and other kinds of white cells (which fight infections).
Fewer normal white cells can cause the person to become infected easily. The infections may be serious as well as life-threatening.
Fewer platelets means that the person may bruise or bleed easily.
Low numbers of red blood cells make the person weak and tire easily. This is called anaemia.
The cancerous white cells multiply quickly. Then, some of them leave the bone marrow and travel throughout the body in the bloodstream. This can lead to problems in other parts of the body.
What are the signs and symptoms of the disease? Being very tired is the most common symptom. An infection may cause very high fevers and may make the person seriously ill.
What are the causes and risks of the disease? It is not known what causes leukaemia.
Exposure to large doses of radiation may lead to AML.
Certain chemicals, such as benzene and cigarette smoke may also cause AML.
Some people with certain genetic defects, such as Down syndrome, develop leukaemia more often than others.
Very rarely, people who have been given certain types of chemotherapy later develop AML.
Some unusual viruses may cause some of the more rare types of AML.
What can be done to prevent the disease? Nothing can be done to prevent AML.
How is the disease diagnosed? AML is diagnosed by examining a blood sample to see if it contains cancerous white cells. Also, the blood sample can be used for special genetic testing. A bone marrow biopsy can confirm that the person has AML.
What are the long-term effects of the disease? This disease can quickly lead to death if it is not treated. If the treatment is effective, the person will recover and live a normal life.
What are the risks to others? There are no risks to others. No one can get AML from a person who has the disease.
What are the treatments for the disease? AML is treated by chemotherapy. This involves a combination of powerful drugs that is given to the person in the veins. These medications are usually given over several months. These medications will kill the AML cells, but they also damage the normal bone marrow. Some people are given bone marrow from another person to help recovery. This is called a bone marrow transplant. It is used only in certain cases.
The first course of therapy is called induction therapy. It is designed to induce a remission, or complete destruction of the AML. After remission, the original treatment is repeated. This is to make the remission last by destroying any remaining disease.
What are the side effects of the treatments? The major side effect of treatment is damage to the bone marrow. This causes low levels of normal white blood cells, red blood cells, and platelets. This leads to other side effects:
Until the bone marrow recovers, the person is at risk for infections. The person will have to be protected from sources of infection, such as raw food or other people with infections. Antibiotics will be given to prevent as well as treat infections.
Because the platelets are damaged, the person will bleed very easily. Replacement platelets will be given as often as needed to prevent excessive bleeding.
Low red cell counts will make the person very tired. This may also damage the heart. Red blood cells will be given often during the course of the treatment.
The person will experience other specific side effects related to the type of drug that is given.
What happens after treatment for the disease? After therapy has been completed, the bone marrow will recover and begin to function normally again. This usually takes several weeks. A cycle of treatment followed by a recovery period may be repeated several times until all signs of AML are gone.
How is the disease monitored? The person will need to have blood drawn and analysed to monitor treatment and recovery. Bone marrow samples will need to be taken again to confirm that the AML has been successfully treated and is in remission. After all therapy has been completed, blood samples will be taken to make sure the person continues to be in remission. Another bone marrow biopsy may also be needed.
Author: Miriam P. Rogers, EdD, RN, AOCN, CNS Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
