Acute myeloid leukemia - adult
Acute myeloid leukemia (AML) is cancer that starts inside bone marrow. This is the soft tissue in the center of bones that helps form all blood cells. The cancer grows from cells that would normally turn into white blood cells.
Acute means the disease grows quickly and usually has an aggressive course.
AML is one of the most common types of leukemia among adults.
Leukemia is a type of blood cancer that begins in the bone marrow. Bone marrow is the soft tissue in the center of the bones, where blood cells are ...Read Article Now Book Mark Article
AML is more common in men than women.
The bone marrow helps the body fight infections and makes other blood components. People with AML have many abnormal immature cells inside their bone marrow. The cells grow very quickly, and replace healthy blood cells. As a result, people with AML are more likely to have infections. They also have an increased risk of bleeding as the numbers of healthy blood cells decrease.
Most of the time, a health care provider cannot tell you what caused AML. However, the following things can lead to some types of leukemia, including AML:
Blood disorders, including polycythemia vera, essential thrombocythemia, and myelodysplasia
Polycythemia vera (PV) is a bone marrow disease that leads to an abnormal increase in the number of blood cells. The red blood cells are mostly affe...Read Article Now Book Mark Article
- Certain chemicals (for example, benzene)
- Certain chemotherapy drugs, including etoposide and drugs known as alkylating agents
- Exposure to certain chemicals and harmful substances
- Weak immune system due to an organ transplant
Problems with your genes may also cause development of AML.
AML does not have any specific symptoms. Symptoms seen are mainly due to the related conditions. Symptoms of AML may include any of the following:
- Bleeding from the nose
- Bleeding and swelling (rare) in the gums
Bleeding gums can be a sign that you have or may develop gum disease. Ongoing gum bleeding may be due to plaque buildup on the teeth. It can also b...Read Article Now Book Mark Article
- Bone pain or tenderness
- Fever and fatigue
- Heavy menstrual periods
- Pale skin
- Shortness of breath (gets worse with exercise)
- Weight loss
Exams and Tests
The provider will perform a physical exam. There may be signs of a swollen spleen, liver, or lymph nodes. Tests done include:
- A complete blood count (CBC) may show anemia and a low number of platelets. A white blood cell count (WBC) can be high, low, or normal.
A complete blood count (CBC) test measures the following:The number of red blood cells (RBC count)The number of white blood cells (WBC count)The tota...Read Article Now Book Mark Article
- Bone marrow aspiration and biopsy will show if there are any leukemia cells.
Bone marrow aspiration
Bone marrow is the soft tissue inside bones that helps form blood cells. It is found in the hollow part of most bones. Bone marrow aspiration is th...Read Article Now Book Mark Article
If your provider learns you do have this type of leukemia, further tests will be done to determine the specific type of AML. Subtypes are based on specific changes in genes (mutations) and how the leukemia cells appear under the microscope.
Treatment involves using medicines (chemotherapy) to kill the cancer cells. Most types of AML are treated with more than one chemotherapy medicine.
The term chemotherapy is used to describe cancer-killing drugs. Chemotherapy may be used to:Cure the cancer Shrink the cancerPrevent the cancer from...Read Article Now Book Mark Article
Chemotherapy kills normal cells, too. This may cause side effects such as:
- Increased risk of bleeding
- Increased risk for infection (your doctor may want to keep you away from other people to prevent infection)
- Weight loss (you will need to eat extra calories)
- Mouth sores
Other supportive treatments for AML may include:
- Antibiotics to treat infection
- Red blood cell transfusions to fight anemia
- Platelet transfusions to control bleeding
A bone marrow (stem cell) transplant may be tried. This decision is decided by several factors, including:
Bone marrow (stem cell) transplant
A bone marrow transplant is a procedure to replace damaged or destroyed bone marrow with healthy bone marrow stem cells. Bone marrow is the soft, fat...Read Article Now Book Mark Article
- Your age and overall health
- Certain genetic changes in the leukemia cells
- The availability of donors
You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone.
When a bone marrow biopsy shows no evidence of AML, you are said to be in remission. How well you do depends on your overall health and the genetic subtype of the AML cells.
Remission is not the same as a cure. More therapy is usually needed, either in the form of more chemotherapy or a bone marrow transplant.
With treatment, younger people with AML tend to do better than those who develop the disease at an older age. The 5-year survival rate is much lower in older adults than in younger people. Experts say this is partly due to the fact that younger people are better able to tolerate strong chemotherapy medicines. Also, leukemia in older people tends to be more resistant to current treatments.
If the cancer does not come back (relapse) within 5 years of the diagnosis, you are likely cured.
When to Contact a Medical Professional
Call for an appointment with your provider if you:
- Develop symptoms of AML
- Have AML and have a fever that will not go away or other signs of infection
If you work around radiation or chemicals linked to leukemia, always wear protective gear.
Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 10/09/2020.
Appelbaum FR. Acute leukemias in adults. In: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff's Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 95.
Faderl S, Kantarjian HM. Clinical manifestations and treatment of acute myeloid leukemia. In: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 59.
National Cancer Institute website. Adult acute myeloid leukemia treatment (PDQ) – health professional version. www.cancer.gov/types/leukemia/hp/adult-aml-treatment-pdq. Updated August 11, 2020. Accessed October 9, 2020.