Acute Myeloid Leukemia (AML)

Reviewed/Revised Jan 2024
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What is leukemia?

Leukemia is a cancer of white blood cells. White blood cells have many jobs, including helping your body's immune system fight off infection. White blood cells form in your bone marrow, the spongy tissue inside your bones.

With leukemia, you have a very high white blood cell count. However, the cancerous white blood cells don't work properly, so you're likely to get infections. Those infections may be life-threatening.

Also, the cancerous white blood cells fill up your bone marrow so it can't make normal blood cells such as:

There are many different types of white blood cells but only 2 main types of leukemia:

  • Lymphocytic leukemia: cancer of lymphocytes, which are one type of white blood cell

  • Myelogenous leukemia: cancer of all the other types of white blood cells

Lymphocytic and myelogenous leukemia can be acute or chronic:

  • Acute: cancer of young cells that spreads quickly and can cause death in 3 to 6 months if untreated

  • Chronic: cancer of mature cells that spreads more slowly

What is acute myeloid leukemia (AML)?

Acute myeloid leukemia (AML) is a cancer of certain types of white blood cells.

AML starts in your bone marrow, the spongy tissue inside your bones. Certain types of very young cells (called myeloid stem cells) in your bone marrow that should develop into different types of white blood cells instead become cancerous. The cancer cells grow and spread into your blood and to other parts of your body.

"Acute" means this type of myeloid leukemia spreads very quickly and needs immediate treatment. It's life-threatening.

  • AML is the most common leukemia in adults, but it can happen to people at any age

  • You may be tired or pale, get infections and fever easily, and bruise or bleed easily

  • Doctors do blood and bone marrow tests to find AML

  • AML is treated with chemotherapy

  • Sometimes AML is caused by chemotherapy or radiation therapy that was given to you to treat a different cancer

  • Without treatment, most people with AML die within a few weeks to months, but with treatment, between 20% and 40% of people can be cured

There are several types of AML. One type, called acute promyelocytic leukemia, is now highly curable.

What are the symptoms of AML?

Symptoms of AML may include:

  • Fever and heavy sweating (from infection or the leukemia)

  • Feeling weak or tired (from anemia)

  • Swollen gums

Leukemia cells get into your blood and move to other organs. They can form small lumps in or under your:

  • Skin

  • Gums

  • Eyes

AML cells can also spread to the brain and spinal cord, causing symptoms such as:

  • Headaches

  • Throwing up

  • Problems seeing, hearing, or balancing

  • Problems with your face muscles

Acute promyelocytic leukemia can also cause:

  • Bleeding or blood clotting problems

How can doctors tell if I have AML?

To tell if you have AML, doctors will:

Other tests to see if AML has spread to major organs may include:

How do doctors treat AML?

Doctors treat AML with chemotherapy. Chemotherapy, often called “chemo,” is when doctors give you one or more very strong medicines to kill your cancer cells. Other types of medicines and treatments are often used along with chemotherapy to treat the cancer. The goal is cure. If you're cured, you have no cancer cells left in your body. If a cure isn't possible, then the goal is to decrease the number of cancer cells and keep that number low for as long as possible.

Chemotherapy may make you sicker before you get better. The medicines:

  • Make you more likely to get infections

  • May cause you to need a blood transfusion

  • Make you throw up, feel weak and tired, or lose your hair

Treatment for AML goes through 2 phases:

  • Induction

  • Consolidation

Induction involves getting several strong chemotherapy drugs. The goal of induction is to kill most or all of your cancer cells (called remission).

Consolidation involves getting the same or different chemotherapy drugs for a few months to keep the leukemia from coming back.

Doctors treat acute promyelocytic leukemia with:

  • Arsenic compound medicines

Relapse

Relapse is very common. Relapse is when a disease comes back after it has been successfully treated. If you don’t relapse within 5 years, you're considered cured.

If your AML comes back after treatment, doctors may do:

With treatment, about 3 out of 10 people with AML are cured. Younger people who are able to tolerate stronger treatment may do better. In acute promyelocytic leukemia, treatments can cure more than 7 in 10 people.

If treatment doesn’t work, you and your doctors may want to consider end-of-life care (for example, hospice).

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