Acute myeloid leukemia (AML) is a type of blood and bone marrow cancer. AML can affect people of any age, but it is most common in adults.
AML occurs when bone marrow produces abnormal blood cells, which reduces the number of healthy blood cells.
AML only accounts for
AML affects slightly more males than females, but roughly
AML is a type of bone marrow and blood cancer. Bone marrow contains blood stem cells, which form blood. Over time, blood stem cells
With AML, the bone marrow develops abnormal myeloid cells called myeloblasts. As the number of myeloblasts increases, the abnormal cells push out healthy cells. This can cause symptoms of AML, such as fatigue and easy bleeding.
AML can cause general symptoms such as:
- fatigue
- unexplained weight loss
- loss of appetite
- fever
- night sweats
AML
- anemia, due to low red blood cell counts, which can cause fatigue and weakness
- persistent or recurrent infections due to low white blood cell counts
- easy bruising and bleeding, nosebleeds, and bleeding gums, due to low platelet counts
Read more about the symptoms of AML.
Risk factors for developing AML
- older age
- being male
- smoking
- exposure to benzene and possibly formaldehyde
- certain chemotherapy drugs, including alkylating drugs and topoisomerase II inhibitors
- radiation exposure
Certain blood disorders and genetic syndromes can increase the risk of AML, including:
- chronic myeloproliferative disorders
- myelodysplastic syndrome (MDS)
- Fanconi anemia
- Diamond-Blackfan anemia
- Li-Fraumeni syndrome
- neurofibromatosis type 1
- down syndrome
Having a close relative with AML, such as a parent or sibling,
If an identical twin develops AML before the age of one, the risk of their twin developing AML is very high.
A doctor will first assess any symptoms, perform a physical exam, and take a full medical history. Doctors
- Complete blood count: This is a blood test that shows levels of red blood cells, white blood cells, and platelets.
- Peripheral blood smear: This checks a blood sample for blast cells, the number and types of white blood cells and platelets, and changes to blood cells.
- Flow cytometry: This uses a fluorescent dye to examine certain features in a sample of cells from blood marrow or blood.
- Bone marrow aspiration and biopsy: This procedure removes a small sample of bone, bone marrow, and blood to examine under a microscope for leukemia cells.
- Cytogenetic analysis: This is a laboratory test that examines the chromosomes for abnormalities that may indicate cancer.
- Molecular testing: This involves checking a bone marrow or blood sample for certain molecules, such as genes or proteins, that may suggest AML.
- Immunophenotyping: This type of testing treats a tissue sample with antibodies to identify and classify cancer cells.
- Reverse transcription–polymerase chain reaction test (RT–PCR): This test looks for certain genetic changes to identify cancer cells and diagnose certain subtypes of AML.
Treatment for AML typically involves
- Remission induction therapy: This is the first treatment phase, which aims to destroy leukemia cells in the bone marrow and blood to put AML into remission. Remission means that signs and symptoms of cancer have decreased or gone away.
- Post-remission therapy: Post-remission, or consolidation therapy, is the second treatment phase once AML is in remission. Post-remission therapy aims to destroy any remaining cancer cells, which could cause AML to relapse.
Doctors use the following treatments for AML:
- Chemotherapy: For AML, chemotherapy drugs target the whole body to kill leukemia cells. People will receive the drugs orally or intravenously. Medications include azacitidine, cytarabine, and daunorubicin.
- Intrathecal chemotherapy: In some cases, AML may spread to the central nervous system (CNS). Intrathecal chemotherapy delivers drugs into cerebrospinal fluid to bypass the blood-brain barrier.
- Radiation therapy: Doctors may use radiation therapy to treat AML. A machine outside of the body delivers radiation to the affected area to destroy cancer cells.
- Stem cell transplant: Chemotherapy can destroy healthy cells alongside cancer cells. A doctor removes stem cells, which are immature blood cells, from a person and freezes them. After completing cancer treatment, people have an infusion to receive the stem cells back. This helps the body replace healthy blood cells.
- Targeted therapy: This type of cancer treatment targets specific cancer cells to destroy them. Targeted therapy for AML may include drugs such as gemtuzumab ozogamicin, midostaurin, and quizartinib.
What are the side effects of AML treatment?
Treatment for AML can cause side effects. These may vary for each person, depending on factors such as treatment type and overall health. In many cases, side effects are short term, but in some cases, can be severe.
Side effects of AML treatment may include:
- low blood cell counts, which may cause symptoms such as fatigue and easy bleeding
- increased risk of infection due to low white blood cell counts
- graft versus host disease (GVHD), which may occur with stem cell transplant from a donor and can be mild to severe
- tumor lysis syndrome (TLS), in which cancer cells release substances into the blood when they die, causing high levels of chemicals that can harm the organs
- differentiation syndrome, which can be a side effect of differentiating agents such as enasidenib, ivosidenib, or all-trans retinoic acid (ATRA)
Before starting treatment, discussing possible side effects with a doctor is important. There are many different therapies that can help manage the side effects of treatment.
Learn more about AML treatment side effects.
The following organizations offer support for people living with AML:
The outlook for AML can vary for each person and depends on factors
- older age
- if AML has spread to the CNS
- systemic infection at diagnosis
- high white blood cell count at diagnosis
- previous cancer treatments
- blood disorders
- if AML has recurred
- AML subtype
For most types of AML, induction chemotherapy will lead to remission in around
A relative survival rate helps give an idea of how long a person with a particular condition will live after receiving a diagnosis compared with those without the condition. For example, if the 5-year relative survival rate is 70%, it means that a person with the condition is 70% as likely to live for 5 years as someone without the condition.
According to data from 2014 to 2020, the 5-year relative survival rate for AML is
AML is a blood and bone marrow cancer. AML can occur at any age but is more common in older adults.
Without treatment, it can progress quickly. Treatment aims to get AML into remission and may include chemotherapy, radiation therapy, and stem cell transplant.