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AcuteMyeloidLeukemia (AML)

Risk Factors:

Some of the factors may increase your chances of developing AML.

Increasing age: 

AML becomes more common as people get older. Adults 65 and older are more likely to develop AML.

Sex:

AML is more common in men than it is in women.

Cancer treatment in the past:

 AML is more likely to occur in people who have received specific types of chemotherapy or radiation therapy.

Radiation exposure:  

AML is more likely to develop in people exposed to high quantities of radiation.

Chemical Exposure and poisoning:

 Exposure to certain dangerous chemicals such as benzene has been related to an increased risk of AML.

Smoking:  

AML has been related to cancer-causing substances found in cigarette smoke.

Other blood disorders:

AML is more likely to occur in those with other blood diseases, such as myelodysplasia, myelofibrosis, polycythemia vera, or thrombocythemia.

 

Genetic Disorders:  

Down syndrome and other congenital abnormalities are linked to an increased risk of AML.

Signs & Symptoms:

The following are some of the signs and symptoms of AML:

·         Fever

·         Breathing difficulties

·         Pale skin

·         Infections

·         Frequent bruising or bleeding

·         Petechia (tiny red dots that appear under the skin brought on by bleeding)

·         Weakness or exhaustion

·         Loss of appetite or weight loss

 

·         Bone or joint pain (If abnormal cells develop near or inside the bones) 

Diagnosis

Your doctor may use a variety of methods to diagnose AML and determine which subtype you have:

 

·         Physical examination and asking detailed medical history

 

·         Blood testing

such as a complete blood count (CBC) and a blood smear. Most people with AML have increased white blood cells but reduced quantities of red blood cells and platelets. However, the number of white blood cells in the body can sometimes be low. Another finding of AML is the presence of blast cells, which are immature cells found in bone marrow but do not circulate in the blood.

·         Bone marrow tests:

 A blood test can indicate leukemia, but a bone marrow test is usually required to confirm the diagnosis. Bone marrow aspiration and bone marrow biopsy are the two most common procedures. Both tests require a sample of bone marrow and bone and are sent to a lab for testing.

·         Genetic tests:

To look for gene and chromosome mutations  

If you've been diagnosed with AML, you'll likely need more testing to detect if cancer has spread.

Imaging tests and a lumbar puncture (a process for collecting and testing cerebrospinal fluid (CSF)) are among them.

·         Lumbar Puncture (Spinal tap):

In certain situations, it may be necessary to remove some of the fluid around your spinal cord to check for leukemia cells. Your doctor can collect this fluid by inserting a small needle into the spinal canal in your lower back.

Complications

You may have complications if you have acute myeloid leukemia (AML). The condition itself can cause these, or they can happen as a result of treatment.

·         Weakened immune system: It is a common complication of AML. This makes you more susceptible to infection, and any condition you have could be more severe than usual.

·         Bleeding: Because of the low levels of platelets (clot-forming cells) in your blood, you may bleed and bruise more frequently. Excessive bleeding is also possible. People with advanced AML are more likely to experience internal bleeding.

 

·         Infertility: It is a side effect of several medications used to treat AML. This is usually just temporary, although it can be permanent in some cases.

Treatment

AML can be treated in a variety of ways, including:

·         Chemotherapy: Chemotherapy is the most common kind of remission induction therapy, although it can also consolidate remission. Chemotherapy is a type of treatment that uses chemicals to eliminate cancer cells in the body. Because the medications kill many normal blood cells while destroying leukemia cells, people with AML usually stay in the hospital throughout chemotherapy treatments. It is possible to repeat chemotherapy if the initial round does not result in remission.

·         Targeted therapy: Targeted medication treatments are designed to target specific abnormalities found in cancer cells. Targeted medication treatments can kill cancer cells by inhibiting these abnormalities. For induction and consolidation therapy, targeted therapy can be administered alone or combined with chemotherapy.

·         Chemotherapy in combination with a stem cell transplant: Consolidation therapy may involve a bone marrow transplant, commonly known as a stem cell transplant which can help restore healthy stem cells by replacing diseased bone marrow with leukemia-free stem cells. You get very high doses of chemotherapy or radiation therapy before transplant to eradicate your leukemia-producing bone marrow. Then you get stem cell infusions from a compatible donor (allogeneic transplant). If you were previously in remission and had your healthy stem cells kept for a future transplant, you can also receive your stem cells (autologous transplant).

·         Other anti-cancer medications

The treatment you receive is often determined by the subtype of AML you have. Treatment usually consists of two stages:

·         The first phase aims to eliminate leukemia cells from the blood and bone marrow, putting leukemia into remission. The term "remission" refers to the reducing or disappearing signs and symptoms.

 

·         Post-remission therapy is the second step of treatment. Its goal is to prevent cancer from relapsing (returning). It involves eliminating any remaining leukemia cells that may or may not be active but can grow back.

Medications

Drugs that target specific regions of cancer cells have been developed in recent years. Targeted medications differ from regular chemotherapy (chemo) drugs in how they function and cause side effects. They can be beneficial even when chemo isn't, or they can be administered in conjunction with chemo to improve its effectiveness.

Certain people with acute myeloid leukemia may be prescribed some of these medicines.

·         FLT3 Inhibitors such as Midostaurin and Gilteritinib

·         IDH inhibitors such as Ivosidenib and Enasidenib

·         BCL-2 inhibitors such as Venetoclax

 

·         Hedgehog pathway inhibitors such as Glasdegib 

Lifestyle Modifications

Stopping smoking is the major modifiable risk factor for AML; quitting offers the best opportunity to lower risk. People who do not smoke are also less likely to get a variety of different cancers and heart disease, stroke, and a variety of other conditions.

Eat Well: Eating well can help you feel stronger and healthier, as well as speed up your recovery.

 

Stay Active: If you're tired and weak, exercising may be the last thing on your mind. However, being as active as possible will provide extra energy and help you overcome fatigue.

Prognosis:

Your doctor will determine your prognosis and treatment options based on your AML subtype and other information. Other cancers have numerical phases that indicate your prognosis and whether your cancer has spread, but AML does not have any. Instead, the severity of your disease is determined by the following factors:

·         Subtype of AML

·         Age

·         Overall health

 

·         Results from diagnostic tests and procedures

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