AML, or acute myeloid leukemia, is a complex form of cancer that grows rapidly and is one of the most aggressive types of cancer. 

AML occurs in the bone marrow, producing a large number of abnormal cells, and causing cancer. It is a swiftly progressive type of cancer that worsens in a short span of time, and immediate treatment is required. There are various risk factors, including smoking, previous history of radiation exposure, inherited disorders, and much more. 

 

In this blog, let’s explore what you need to know about acute myeloid leukemia and the best cancer hospitals in Chennai. 

 

Understanding Acute Myeloid Leukemia

Understanding Acute Myeloid Leukemia

Acute myeloid leukemia is the most common type of acute leukemia and is a cancer of the bone marrow and blood. AML is also known as acute myelogenous leukemia and acute nonlymphocytic leukemia.

 

The human bone consists of three layers. 

 

  1. Compact bone: the outer layer 
  2. Spongy bone: found mostly at the ends and contains red marrow. 
  3. Bone marrow is the inner layer of bone and contains blood vessels. 

 

Red marrow, found in the spongy bone, contains blood stem cells that eventually mature and become RBCs, WBCs, and platelets. Yellow marrow is made mostly of fat. 

 

Acute myeloid leukemia occurs in the process of new blood cell formation from the stem cells, causing cancer. It is characterized by an increase in the number of immature white blood cells and myeloblasts. As a result, these immature cells, called leukemia cells, increase in number in the blood and bone marrow, which restricts the space for healthy red blood cells, white blood cells, and platelets. The cancerous cells may spread to other parts of the body and sometimes form a tumor called myeloid sarcoma. 

 

Risk factors and symptoms of AML 

 

AML occurs due to changes in the growth and division of the blood stem cells, which can be due to different factors. Certain factors cannot be changed, like genetics, and health history, however, certain risk factors can be addressed and prevented. 

 

These risk factors don't cause cancer directly but increase the chances of DNA damage that may cause AML. Many people with risk factors may not develop cancer, while people with no risk factors may have the disease. 

 

Risk factors are: 

  1. Smoking 
  2. History of chemotherapy or radiation therapy treatment 
  3. Exposure to radiation in the environment, such as nuclear radiation or chemical benzene 
  4. Blood disorders like myelodysplastic syndrome
  5. Older age and being male 
  6. Inherited disorders 

 

Early symptoms of acute myeloid leukemia may be similar to those of the flu.

 

  1. Fever 
  2. Infection 
  3. Bleeding 
  4. Fatigue and weakness 

 

Symptoms of AML are usually observed to develop 4–6 weeks before diagnosis. 

 

Diagnosis and staging 

Your healthcare professional may ask about your family health history and apparent symptoms. Furthermore, the below test may be done to diagnose the cancer. 

 

A complete blood count (CBC) is a laboratory test done to check the number of RBCs, WBCs, and platelets. The hemoglobin content of RBCs and the amount of hematocrit are also checked. 

 

Peripheral blood smear: The test is done to check for blast cells, the number of WBCs, and platelets, and to assess any changes in the shape of blood cells.

 

Flow cytometry is done to measure the number of cells in the sample and certain characteristics, such as size, shape, and percentage of live cells. 

 

Tumor Biopsy: Here, cells or tissues are removed from the lump using a needle. This is done if the doctor suspects the formation of a tumor, called myeloid sarcoma. 

 

Cytogenic analysis: The test is done to count the number of chromosomes in a sample and check for any changes, including broken, extra, rearranged, or missing chromosomes. 

 

Molecular analysis is done to check for proteins, genes, and other molecules in bone marrow. It may also check for changes in genes or chromosomes that may cause AML. 

 

Immunophenotyping: Here, antibodies are used to identify cancer cells, depending on the type of antigens or markers on the surface of the cells. 

 

Reverse transcription-polymerase chain reaction (RT-PCR) is employed to measure the amount of genetic substance, mRNA, made by a specific gene. RT-PCR is used to check the activation of certain genes that may indicate the existence of cancer cells. 

 

If AML is diagnosed, further tests are done to determine whether the cancer has spread to other parts of the body. 

 

  1. Lumbar Puncture: In this test, a sample of cerebrospinal fluid from the spinal column is collected by placing a needle between two bones in the spine. The sample is then checked under a microscope for any signs of leukemia having spread to the spinal cord and the bone. 
  2. CT Scan: Using an X-ray machine connected to a computer, a series of pictures of the abdomen are taken from different angles.

 

When it comes to AML, there’s no standard staging system. AML treatment depends on the subtype of AML, whether it has spread outside the blood and bone marrow, and whether it is newly diagnosed, in remission, refractory, or recurrent. 

 

Treatment Options

 

There are various types of treatment available for AML. It generally has two phases, and the treatment causes side effects; hence, support is essential. 

 

Factors such as the phase of the cancer, overall health, and preferences will be considered before your healthcare professional decides on the treatment plan. 

 

The two phases of the treatment plan are: 

 

  1. Remission Induction Therapy: Here, the aim is to kill the leukemia cells in the bone marrow and blood. 
  2. Postremission Induction Therapy: Here, the aim is to kill any remaining leukemia cells that may cause a relapse or the regrowth of the cancer. 

 

Chemotherapy

Chemotherapy is the treatment of cancer using drugs, either to stop the division of the cancer cells or to kill them. The treatment depends on the subtype of AML and if the cancer has spread to the CNS. In systematic chemotherapy, drugs are injected into the bloodstream through the veins or muscles. A combination of drugs may be used for the treatment. In cases where cancer has spread to the central nervous system, intrathecal chemotherapy may be used, where chemotherapy is placed directly into the cerebrospinal fluid. 

 

Targeted Therapy

 

Targeted therapy uses drugs to identify and attack specific cancer cells. This treatment targets proteins that control how cancer cells grow, divide, and spread. 

Stem Cell Transplant

 

High doses of chemotherapy kill cancer cells, but they destroy blood-forming healthy cells. A stem cell transplant replaces those blood-forming cells, either from your own stem cells or from a donor. Stem cells are taken from the bone marrow or blood of the donor and are frozen until the end of chemotherapy. Later, the stem cells are given through a tube into the blood vessels, similar to chemo. 

 

Radiation Therapy

In radiation therapy, high-energy X-rays or other types of radiation are used to kill cancer cells and also keep them from growing. AML may be treated with external radiation therapy. It can also be used to prepare the body for a stem cell transplant when the leukemia has reoccurred. 

 

Managing treatment side effects

 

Treatment of AML is often accompanied by side effects. 

 

  1. Appetite loss
  2. Constipation 
  3. Anemia 
  4. Fatigue 
  5. Hair loss
  6. Fertility issues 
  7. Infections 
  8. Pain 
  9. Nausea and vomiting 
  10. Bruising or bleeding easily 

 

Your doctor may prescribe antibiotics to avoid any infection, and it is important to stay in clean environments to avoid any potential infections. 

 

The side effects go away after the treatment is done, and care is needed during the entire process. Also, make sure to inform your care team about the troublesome side effects, as they will be able to provide relief and comfort. 

 

Prognosis and follow-up care

Follow-ups are required throughout and after the cancer treatment. Tests are done at regular intervals to analyze how well the treatment is working. 

 

Follow-up care is important, as it can indicate if the cancer has reoccurred. 

 

Cancer is hard, and it may make you feel a wide range of emotions, affect your body image, and interfere with your professional and personal life. All these are valid, and that is why it is important to cope with the effects and aftermath of cancer. Your family may also have a hard time on this journey, and it is a good thing there are various ways to cope with cancer. 

 

Reach out for emotional support, and it will help you traverse this journey. 

 

Conclusion

Acute Myeloid Leukemia (AML) indicates a large number of abnormal cells in the bone marrow. It may affect the RBCs, WBCs, and platelets. AML progresses rapidly, and it is important to have immediate treatment. 

 

There are different types of treatment, including chemotherapy, radiation therapy, stem cell transplants, etc. Although the treatment is accompanied by side effects, they get better once the treatment is successfully completed. 

 

If you experience any symptoms and doubt that you have AML, it would be wise to consult your healthcare professional.

 

With a team of experienced doctors and expertise in cancer treatment, Oxymed Hospital is one of the best hospitals for AML treatment in Chennai. We strive to offer the best cancer treatment and also support the patient’s journey to a cancer-free life with compassion and care.