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Leukaemia is cancer of the blood cells, starting in blood-forming tissue such
as bone marrow, which makes the cells that become white blood cells, red blood
cells and platelets. In leukaemia the marrow makes large numbers of abnormal
cells — usually white cells — which crowd out the healthy ones.
Acute myeloid leukaemia is an acute leukaemia: **"acute" means it usually
gets worse quickly if untreated**. In AML the marrow makes abnormal
myeloblasts (a type of white cell), red cells or platelets. As the
abnormal cells crowd out healthy ones the result is infection, anaemia and
easy bleeding, and the abnormal cells can spread beyond the blood.
There are several subtypes, defined by how developed the cancer cells are
at diagnosis and how different they are from normal cells. Which subtype you
have often decides which treatment you get.
Cause and risk
AML happens when the DNA in bone marrow cells changes, and **the cause of
those changes is unknown**. Factors that raise the risk:
- Being male
- Smoking, especially after 60
- Previous chemotherapy or radiation therapy
- Treatment for acute lymphoblastic leukaemia as a child
- Exposure to benzene
- A history of another blood disorder, such as myelodysplastic syndrome
Three of those six are consequences of earlier medical treatment, which is a
hard thing about AML rather than an argument against the earlier treatment.
Symptoms
Fever · shortness of breath · easy bruising or bleeding · petechiae, tiny
red dots under the skin caused by bleeding · weakness or tiredness · weight
loss or loss of appetite · bone or joint pain, where the abnormal cells
build up near or inside the bones.
Diagnosis
A physical exam and medical history, blood tests (a complete blood count
and a blood smear), bone marrow tests — aspiration and biopsy, both taking
a sample of marrow and bone — and genetic tests for gene and chromosome
changes, which also establish the subtype. After a diagnosis, imaging and a
lumbar puncture show whether it has spread.
Treatment, in two phases
Chemotherapy · radiation therapy · chemotherapy with a stem cell transplant ·
other anticancer medicines. Which you get often depends on the subtype.
| Phase | Goal |
|---|---|
| First | Kill the leukaemia cells in the blood and bone marrow, putting the leukaemia into remission — signs and symptoms reduced or gone |
| Second: post-remission therapy | Prevent relapse by killing any remaining leukaemia cells that may not be active but could begin to regrow |
The second phase is aimed at cells that cannot be detected and are not
currently doing anything. That is why treatment continues after the scans come
back clear, and why "remission" is a stage rather than a finish.
Source: National Cancer Institute, via MedlinePlus.
Licence: CC0 1.0 (public domain) · Adapted from medlineplus.gov
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