Complete guide-Acute Myeloid Leukemia Symptoms And Treatment

Acute Myeloid Leukemia 

Acute myeloid leukemia is cancer found in the blood and bone marrow, because of excessive production of myeloblast (immature white blood cells) which overcrowds the bone marrow and blood and even leaks into the bloodstream and gets to other parts of the body. The myeloblasts which are produced in excess affect the normal function of the blood by hindering the production of normal blood cells.

Acute Myeloid Leukemia Symptoms,Acute Myeloid Leukemia treatment and causes


This is the reason why in people with excess production of immature white blood cells there is usually the problem of anemia and susceptibility to several infections because the immature white blood cells are unable to fight against infections or stop the body from being infected. AML occurs in men more than in women, and people older than 65 years are likely to have it more than of a younger age.

Acute myeloid leukemia causes

The cause of acute myeloid leukemia is due to damage of some genes which functions in the control of the development of blood cell. The common risk factors of acute myeloid leukemia are usually radiation in a very high dose which maybe as a result of a nuclear accident or as a form of therapy, for example during treatment of other cancers.

Other risk factors are severe exposure to occupational chemicals such as long-time exposure to benzene, and other fumes that are cancerogenic even inhaling tobacco smoke (some of the substances in tobacco smoke are cancerogenic).

Also, some other blood diseases are risk factors for acute myeloid leukemia. Such diseases are disseminated intravascular coagulation (DIC), myeloproliferative disorders (MPD) and myelodysplastic syndromes (MDS).

Preexisting genetic disorders can also be average risk factors such as Down syndrome, Fanconi’s anemia, bloom’s syndrome.


Acute myeloid leukemia symptoms

The symptoms of acute myeloid leukemia are:


  • Getting bruises
  • Regular nose bleeds
  • Swelling of gums,
  • The difficulty of blood clotting
  • Pain in bones
  • Low platelets counts 
  • Shortness of breath
  • severe headaches


These symptoms are a result of thrombocytopenia and symptoms related to anemia seen in the people with AML are weakness and easy fatigue, especially after exercise.

When such symptoms are noticed it is best to go to the hospital for further investigation and confirmatory diagnosis which is done by performing full blood count (FBC), and bone marrow biopsy. When the diagnosis is made as acute myeloid leukemia, treatment should be started immediately without delays to stop any further damage being done to the blood system function.

Acute myeloid leukemia treatment


The best line of treatment for acute myeloid leukemia is chemotherapy. This treatment is carried out in two phases; the first phase of the treatment is the induction phase where remission is done. The goal of the induction phase is to eliminate all cells of leukemia from the bone marrow and bloodstream to an undetectable level.

In this phase doses of chemotherapy are given cytarabine is administered intravenously at 100 to 200 mg/m2 /day for 7 days, in the combination of anthracycline also given intravenously 45 to 60mg/m2 for the 1st, 2nd, and 3rd day of treatment this is a combined therapy. After this treatment then the second phase is started which is the phase of post-remission and here the chemotherapy is given to restore normal blood cell levels and function. If chemotherapy fails then bone marrow transplant is done.


Acute myeloid leukemia risk factors and causes


There are several known Acute Myeloid Leukemia risk factors (AML). These factors are discussed below:

Smoking

This has been a risk factor for Acute Myeloid Leukemia. Most people are aware that smoking has a link to cancers of the throat, mouth, and lungs. Only a few know that smoking also affects the cells that are not in direct contact with cigarette smoke.  The substances in tobacco smoke that cause cancer to find their way into the bloodstream and they spread to other parts of the smoker’s body.

Chemicals

Exposure to some chemicals is a link to acute myeloid leukemia. Long exposure to benzene at high levels is among the risk factors for AML. Benzene is a solvent that is used for cleaning. It is used for the production of plastics, dyes, drugs, and gasoline. Patients who other types of cancers that are treated with some chemotherapy drugs are more susceptible to AML. Using chemotherapy drugs together with radiation further increases the risk of developing  AML.

Radiation

Exposure to high doses of radiation is an AML risk factor. This is the reason why those who survived an atomic bomb explosion in Japan had an increased risk of contracting acute leukemia within a period of six to eight months. The risk of getting acute myeloid leukemia from exposure to lower radiation like the one that results from x-rays, CT scans is not very clear. It is also not clear if radiation exposure to a fetus within the early period of development is among the Acute Myeloid Leukemia risk factors. If the exposure to lower levels of radiation increases the risk of acquiring AML, it is likely to be small.  However, many doctors try all they can to limit radiation exposure to patients.

Blood  problems

Some patients have some blood problems that put them at a higher risk of getting AML. If the body is not making enough platelets or has excess red cells, there is increased risk. Some people suffer from chronic myelogenous leukemia that is known to later develop into a form of the AML. The chances of contracting AML  is higher when radiation and some kinds of chemotherapy are used when treating some of these blood problems.

AML on identical  twin

Having a twin who suffers from Acute Myeloid Leukemia is another risk factor. This risk most occurs during the early years of life.  Many medical practitioners feel that the risk is high due to the passage of leukemia cells from one fetus to another when they are in the mother’s womb.

Gender

Acute Myeloid Leukemia is more common among men than in women. It is not clear why the men are at more risk of getting AML than women. The average age of getting AML is 67 with lifetime risk among the average man being 1 in 250. The risk for an average woman is approximately 1 in 300. Most of the AML cases occur in adults.

Acute Myeloid Leukemia Prognosis


Acute myeloid leukemia is a cancer of the blood and bone marrow which occurs as a result of the overproduction of immature white blood cells.  These immature white blood cells are also called myeloblasts. the AML present in the bone marrow hinders the normal blood cells from being produced and therefore the function of the blood is affected and the normal blood cell function is reduced.  This causes anemia and the patients easily have bruises.

Acute myeloid leukemia is a disease that is more common in people older than 65 years and is it is often seen in men than women.  One of the symptoms of the disease is anemia which would result in weakness and fatigue during physical activity.  The reduction of normal blood cells and platelets will make the person have nose bleeding and difficulty in blood clotting.

Some patients also have swollen gums, fever, shortness of breath and even skin pallor.  There are risk factors that possibly affect the prevalence of AML these are; some pre-existing blood conditions (thrombocytopenia) and also genetic disorders such as Down’s syndrome.

The diagnosis of acute myeloid leukemia is not only based on a patient’s complaints or past history but also on clinical blood analysis and bone marrow biopsy.  In full blood count, there is severe anemia and excessively reduced platelets. And in bone marrow aspiration (bone marrow biopsy) the presence of leukemia is seen. When acute myeloid leukemia is diagnosed further tests are carried out to identify the blood type involved to differentiate the particular subtype of AML present (M0-M7 subtypes) all of which have its own type of blood cell defect.

The acute myeloid leukemia survival rate

The treatment of acute myeloid leukemia is usually by chemotherapy which destroys the leukemic cells and restores the quantity and function of the normal blood cells. Antibiotics are also given to treat infections and help the body fight the infections, platelet transfusion is done to help control the excessive bleeding and blood components are infused to help reduce anemia.

Chemotherapy has its own side effects in that it does not only kill cancer cells but destroys normal cells as well, making the immune system weaker and increasing the possibility of the patient getting infections, therefore the patients with acute myeloid leukemia during treatment are separated from other people to reduce contacting any form of infections. Other complications that can arise due to the treatment include severe bleeding that could be threatening to life and sometimes the cancer returns after treatment is already completed (relapse).

When the symptoms are no more seen after a period of treatment, the patient is said to be in remission, but in most patients, complete remission occurs.  There is a 5 years survival rate being used if cancer does not relapse within 5 years after diagnosis and treatment the patient is considered as being permanently cured. Though, such cases are more common in younger people than in patients above 65 years.

To prevent acute myeloid leukemia, if you work around strong radiation or occupational chemicals always use your headgear and follow other protective measures advised. This will not only save you from leukemia but also from other forms of cancers.

Living with acute myeloid leukemia prognosis


Acute myeloid leukemia is a type of cancer that affects both the blood and bone marrow. Acute myeloid leukemia is a defective disease where immature white blood cells (myeloblast or leukemic blast) are overproduced. The myeloblast is in excess in the bone marrow and in the blood, overcrowding them, and preventing them from producing normal blood cells.  These immature white blood cells can also be released into the bloodstream and circulate throughout the entire body. Their immaturity makes it impossible for them to function properly, therefore they are unable to either prevent infections or even fight against them. There is also anemia in these patients due to inadequate red blood cells and platelets produced by the blood and bone marrow. The reduced platelets also lead to getting easy bleeding and bruising.

Acute myeloid leukemia is also called granulocytic leukemia or myelogenous leukemia. This disease occurs in people of all ages but is more frequent in people older than 65 years.

The prognosis of acute myeloid leukemia (the possible outcome of the disease, the response to treatment) is dependent on the type of cytogenetic changes involved. Therefore some AML have a better favorable prognosis than others, some forms of acute myeloid leukemia respond very well to treatment and are even cured. Such AML with good prognosis include;  a chromosome 16 inversion, chromosome 8 and 21 translocations, chromosome 15 and 17 translocations and also cytogenetic changes seen in a subtype of acute myeloid leukemia known as acute promyelocytic leukemia (M3). The acute promyelocytic leukemia is treated differently from other AML and it has the best prognosis in all.

There are some other forms of acute myeloid leukemia with cytogenetic changes that have an intermediate prognosis and some others do have a poor prognosis. Anyway in AML, there are no good or bad risk cytogenetic changes, people with normal cytogenetic changes are seen as having an average prognosis.

The symptoms of acute myeloid leukemia are; nose bleeding, easily bruised, fatigue especially after physical activity, prone to different infections and difficulty of wound healing due to lack of proper function of white blood cells. It is also good to note that some subtypes of acute myeloid leukemia have some specific symptoms. In some subtypes, leukemic cells spread from the circulating blood into other tissues of the body, for example into the gum where it causes swelling of the gums and discomfort. In Acute promyelocytic leukemia, there could be bleeding and abnormal blood clotting.

For the diagnosis of acute myeloid leukemia the easiest way is by carrying out full blood count and bone marrow biopsy this reveals the pathology of acute myeloid leukemia.

In treating a patient with acute myeloid leukemia it is best to start immediately after diagnosis because the disease has a very fast progression rate. The best treatment is with chemotherapy whose aim is to first destroy the leukemic cells and then induce remission. Normally if chemotherapy is successful it removes all pathological cells completely and restores normal blood cell production and function. When remission is gained, a different dose of chemotherapy is given to prevent leukemia from occurring (relapse). This second dose is called the consolidation therapy. If chemotherapy fails bone marrow transplant is done with an appropriate donor.

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