Definition

Acute myeloid leukemia (AML) is a cancer of the blood and bone marrow. With AML, the bone marrow makes abnormal blood cells including:

• Myeloblasts—a type of immature white blood cell
• Red blood cells (RBCs)—carry oxygen
• Platelets—a blood cell that helps blood to clot

These abnormal cells crowd out the healthy cells. AML gets worse quickly. Without normal cells, anemia, bleeding problems, and infections easily develop.

White Blood Cells Copyright © Nucleus Medical Media, Inc.

Causes

Cancer happens when cells divide without control or order. These cells grow together to form a tumor. They can invade and damage nearby tissues. They can also spread to other parts of the body.

It is not clear what causes changes in the cells. It is likely a combination of genes and environment.

Risk Factors

Things that may raise the risk of AML in children are:

• Certain genetic problems, such as Down syndrome
• Exposure to radiation
• Exposure to certain chemicals such as benzene
• A history of other blood disorders such as polycythemia vera, essential thrombocytosis, or myelodysplastic syndrome

Symptoms

AML may cause:

• Painless lumps in the neck, underarms, stomach, or groin
• Red or purple spots under the skin
• Easy bruising or bleeding
• Fever, tiredness, weakness, and paleness
• Problems breathing and chest pain
• Loss of hunger and weight loss
• Bone or joint pain

Diagnosis

The doctor will ask about your child’s symptoms and health history. A physical exam will be done. The doctor will check for swelling of the liver, spleen, and lymph nodes. The child may be referred to a cancer doctor.

Tests will be done to look for abnormal cells. They may include:

• Blood tests
• Bone marrow biopsy or aspiration—to remove and test a sample of bone marrow
• Lumbar puncture—to test the fluid around the brain and spinal cord for cancer

The doctor may do more tests to learn about the leukemia. These tests will help guide treatment. Tests may include:

• Cytogenetic analysis—to look for changes in white blood cells
• Immunophenotyping—to check the type of leukemia
• Imaging tests to check bodily structures, including:
  • Ultrasound
  • Chest x-ray
  • CT scan
  • MRI scan
  • Gallium scan and bone scan

AML is then classified into subtypes. This helps the doctor outline a treatment plan.

Bone Marrow Biopsy Copyright © Nucleus Medical Media, Inc.

Treatment

Treatment of AML is usually done in two phases:

• Remission induction therapy—to kill leukemia cells
• Consolidation—to kill any remaining leukemia cells that could grow and cause a relapse

Treatment may include:

• Chemotherapy by mouth, injection, or IV—to kill cancer cells
• External radiation therapy —targets a certain part of the body
• Stem cell transplant—blood cells given from a donor
• Other medicines— to kill leukemia cells, stop them from dividing, or help them mature
• Biological therapy—helps the body fight cancer
• Antibiotics to treat and prevent infections
• Medicines to treat side effects

Prevention

There are no current guidelines to prevent AML.