Acute myeloid leukemia (AML) is a cancer of the haematopoietic system that mostly affects adults. The risk of its development increases with age. People over the age of 65 are particularly at risk. What are the causes and symptoms of acute myeloid leukemia? What is the treatment?

Acute myeloid leukemia(AML -acute myeloid leukemia ) is a cancer of the bone marrow - the tissue that fills the bones, which is responsible for the production of red blood cells ( red blood cells), leukocytes (white blood cells) and platelets, which are the basic elements of the blood.

In the course of acute myeloid leukemia, white blood cells - specifically leukocytes from the granulocytic line - are changed neoplastic, which multiply in an uncontrolled way, accumulate, displacing he althy cells and leading to the appearance of disease symptoms.

Acute myeloid leukemia is dominant in adults - unlike acute lymphoblastic leukemia, which usually develops in children.

The incidence of acute myeloid leukemia is approximately 3.7 per 100,000 people per year, and is higher in men than in women.

Acute myeloid leukemia - causes and risk factors

The reasons for the development of acute leukemia are unknown, but a lot is known about the factors that increase the risk of its development:

  • Congenital genetic diseases such as, incl. Fanconi anemia, Bloom syndrome, Shwachman-Diamond syndrome, Ataxia-telangiectasia syndrome, Down syndrome and Kostmann syndrome
  • ionizing radiation
  • exposure to chemicals such as benzene, petroleum transformation products, paints, embalming fluids, ethylene oxide, herbicides and pesticides
  • smoking
  • some drugs - mainly used to treat other cancers. Bone marrow damage with subsequent development of AML after chloramphenicol (antibiotic), phenylbutazone (non-steroidal anti-inflammatory drug) and (less frequently) chloroquine and methoxypsoralen has also been described.

In addition, acute myeloid leukemia can develop as a result of blastic transformation of chronic myeloid leukemia or myelodysplastic syndrome.

Acute myeloid leukemia -symptoms

Symptoms of acute myeloid leukemiato:

  • general symptoms of anemia such as pallor, apathy, increasing fatigue, weakness
  • increased susceptibility to bruising
  • petechiae and lumps on the skin

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  • bleeding from the mucous membranes of the mouth and bleeding from the nose
  • gingival overgrowth
  • lymph nodes enlargement
  • low fever
  • pain in limbs

Other unusual symptoms may also appear, such as enlarged salivary glands and lacrimal glands (Mikulicz's syndrome).

Important

Acute myeloid leukemia can attack the nervous system

manifest leukemia of the central nervous system can manifest as vomiting and headaches, as well as paralysis of the cranial nerves.

AML and COVID-19 - recommendations for patients

AML patients who are asymptomatic and not receiving treatment should discuss the need for a clinic visit with their physician. Specialists offer remote assistance - by phone or as part of a telemedicine visit.

Patients who are on active treatment or receiving blood transfusions should continue to attend scheduled appointments unless otherwise decided by the he althcare team. Before each scheduled visit, the patient should contact their physician to make sure that the visit is necessary and possibly consider making a visit by phone or video connection. Blood collection from the patient should take place at home or in the nearest clinic to avoid patient movement.

All patients should avoid travel, contacts with people who have recently traveled to countries with COVID-19 outbreaks, anyone who shows respiratory symptoms, and people who may have come into contact with an infected person. In addition, they should remember to wash their hands properly and carefully.

People with symptoms of cough, fever, diarrhea, or chills (specific to COVID-19) should contact their doctor or hotline as soon as possible for instructions on what to do before going to the clinic. During a visit to the hospital or clinic, the patient should wear a mask that covers both the nose and mouth.

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Acute myeloid leukemia - diagnosis

If leukemia is suspected, a blood count is performed. Genetic characterization of leukemia cells is also necessary.

Thanks to this examination, it is possible to determine the prognosis of the patient and which method is best to treat him. Final diagnosis is made on the basis of cytological examination of the bone marrow.

The doctor should rule out other diseases, such as:

  • infections (sepsis, osteitis, infectious mononucleosis, cytomegaly, toxoplasmosis)
  • systemic and neoplastic diseases (neuroblastoma and other solid tumors)
  • aplastic anemia
  • myelodysplastic syndrome
  • myeloproliferative syndrome
  • non-Hodgkin's lymphoma

Acute myeloid leukemia - treatment

The treatment of acute myeloid leukemia is mainly bone marrow transplant, but the main problems limiting its applicability are the lack of a compatible donor and high early mortality due to organ toxicity, infection or graft versus host disease.

Chemotherapy is also used, the aim of which is complete remission, i.e. the disappearance of disease symptoms.

However, not all patients can receive chemotherapy. Contraindications to its use are poor general condition (PS, performance status) assessed according to the Eastern Cooperative Oncology Group (ECOG) scale and the presence of severe comorbidities.

Acute myeloid leukemia - prognosis

Untreated acute myeloid leukemia leads to death within 2-3 months of diagnosis. In patients who receive standard chemotherapy, complete remission (disappearance of disease symptoms) is achieved in 50-80%. cases. In 60-85 percent Patients have relapsed leukemia within 2-3 years of remission.

Category:

Oncology