Also called Acute Myeloblastic Leukemia, Acute Granulocytic Leukemia, Acute Nonlymphocytic Leukemia or Acute Myeloid Leukemia
AML is the most common form of leukemia, affecting nearly 12,000 people in the United States every year. Most people diagnosed with AML are adults around the age of 65, with less than 10% of cases affecting children. The Bone Marrow Transplant Unit at Hospital Angeles Lomas has successfully performed stem cell transplants on adults and children with AML. We know that making a decision on the best course of treatment for you or a loved one can be very difficult so to help we offer a no-obligation, free consultation to patients and their loved ones to discuss their treatment options.
Our bone marrow produces millions of blasts, which are immature white blood cells that go on to form one of a range of white blood cells, helping to fight infection. In AML, these blasts reproduce at a rapid rate but are abnormal so they do not turn into mature white blood cells. Instead, they seep out of the bone marrow into the blood stream, making it difficult for normal blood cells to survive. As the leukemia cells multiply, healthy red and white cells and platelets are killed off to make room for more abnormal blasts.
Because a patient with AML has lower numbers of healthy white cells, to fight infection, red cells, to carry oxygen around the body and platelets, to control bleeding in the body, it can result in the following symptoms:
- Anemia; due to the lack of red blood cells in the blood, oxygen is not carried around the body.
- Fever and infections due to the lack of infection-fighting healthy white blood cells.
- Bruising, blood blisters or red spots caused by low platelet levels (platelets help blood to clot).
- Joint and bone pain, caused by the leukemia cells.
Types of AML and Diagnosis
There are eight types of AML, named M0-M7, depending on the type of blood cells that the leukemia affects.
Blood tests will show high levels of white cells in patients with AML and a bone marrow sample will enable a doctor to see the types of cell that are affected, levels of healthy and unhealthy cells produced, the chromosomal changes that have occurred in the leukemia cells (cytogenetics) and other genetics that can affect the prognosis of the disease, for example the FLT3 mutation, which switches off the enzyme that controls blood cell production, increasing the production of abnormal cells.
AML progresses very quickly so your doctor will usually want to begin treatment straight away. Depending on the subtype of AML that you have, other risk factors (like the FLT3 mutation), your age and general health, your doctor will look at your overall prognosis and try to decide the best treatment option available for you. This may involve chemotherapy, bone marrow or cord blood transplant or placement on a clinical trial.
Whilst your doctor will suggest the best treatment for you within the constraints of their hospital, budget and approved methods, it is important for you to remember that there are other trials and treatments available outside of your own hospital and even your own country, that may be more effective then the treatment offered to you and will most definitely be cheaper.
AML and BMT
If you have AML and your bone marrow is flooding your blood with leukemia cells, chemotherapy may help to kill those cancerous cells, bringing you into remission. However, the chances of relapse in AML are fairly high; you need just one abnormal blast to reproduce in order for the leukemia to come back. If this happens it is possible that the cancer cells will have developed an immunity to the chemotherapy used the first time around, so it is harder (although not impossible) to achieve remission again.
Bone marrow and cord transplants involve killing off all of the existing bone marrow and placing healthy stem cells into the patient’s bone marrow, with the hope that the new stem cells will reproduce to form healthy, leukemia-free bone marrow. Additionally, if relapse does happen after the transplant, the donor cells used in the initial transplant can be used again to fight the leukemia.
For many patients, bone marrow transplant will offer the best chances of achieving remission and staying in remission. Usually before a transplant, high intensity chemotherapy is given to kill off any remaining abnormal bone marrow. This is known as a myeloablative transplant. However, because many patients with AML are aged over 60, such intensive treatment is considered too risky so lower intensity chemotherapy, known as non-myeloablative treatment, is a safer option.
Making a Decision
It is important to remember that the treatment offered by your own hospital may be limited by resources, budget and ability. Researching other options, such as private hospitals and clinical trials will enable you to make an informed decision on the courses of treatment that you could have, not just the ones available to you in your local hospital.
Whilst bone marrow and cord blood transplants do carry risks, they also offer the best chances of long term survival for many people with AML. Your doctor here will help you to weigh the risks against the benefits to decide the best course of treatment for you.
If you would like a free consultation with a medical professional please contact us and we’ll make sure the right person gets back to you.