What Is Acute Myeloid Leukemia?

What is the definition of AML?

Acute myeloid leukemia (AML) is also called acute myelogenous leukemia. It is a cancer of the bone marrow and blood cells. Bone marrow cells in AML patients are not as mature as they are supposed to. Because of its “acute”, AML can quickly be life-threatening.


How to diagnose AML?

If you feel the signs or symptoms of AML auch as constant tiredness or weakness, stomach pain, headache, vision problems, loss of appetite or weight without trying, you may need to do the following tests to examine whether you have AML:

  • Blood tests: It can be used to find whether there are immature cells (blast cells) in bone marrow.
  • Lumbar puncture (spinal tap): In order to check leukemia cells, it will insert a small needle into the spinal canal in lower back to collect the fluid around spinal cord.
  • Bone marrow test: It used to confirm diagnosis.
  • Genomic testing: It is a kind of laboratory test, used to find genetic changes or mutations, thus guiding treatments and determining prognosis.

What is the life expectancy of leukemia?

It is estimated from National Cancer Institute that the average life expectancy for people with leukemia is 72 years for men and 78 years for women.


What are the survival rates for AML patients?

For patients younger than 60, after the first round of chemotherapy, roughly 70 to 80 percent will go into remission.

However, for patients older than 60, they have a higher risk of dying during treatments.

For higher risk AML groups, an estimated 26% AML patients are still living five years after the diagnosis.

For lower risk AML groups, an estimated 65% AML patients are still living five years after the diagnosis.


What are the medications for AML?

Chempotherapy is the major treatment for AML patients. The following are some chemo drugs used most often for AML patients:

  • Cytarabine (cytosine arabinoside or ara-C)
  • Anthracycline drugs: such as daunorubicin (daunomycin); idarubicin; mitoxantrone
  • Cladribine (Leustatin®, 2-CdA)
  • Fludarabine (Fludara®)
  • Topotecan
  • Etoposide (VP-16)
  • 6-thioguanine (6-TG)
  • Hydroxyurea (Hydrea®)
  • Corticosteroid drugs: such as prednisone; dexamethasone (Decadron®)
  • Methotrexate (MTX)
  • 6-mercaptopurine (6-MP)
  • Azacitidine (Vidaza®)
  • Decitabine (Dacogen®)

After the chemo, the following drugs are often given to increase the white blood cell counts, thus reducing the chance of infection:

  • G-CSF (filgrastim, Neupogen®)
  • GM-CSF (sargramostim, Leukine®)


What prognostic factors affect AML?

Here are some prognostic factors that may affect the cure for AML:

  • Myelodysplastic syndrome: AML which is related with pre-existing myelodysplastic syndrome has a worse prognosis.
  • Cytogenetics: It means the chromosomal structure of leukemic cells. Cytogenetic abnormalities may result in poor prognosis and may pose a higher risk for relapse after treatments.
  • Age: Patients older than 60 years old have poorer outcomes.
  • Performance status: It means the physical condition and activity level.
  • Genotype: Molecular alterations like FLT3-ITD, NPM1 and CEBPA may have mixed outcomes for AML prognosis. FLT3-ITD has shown to confer a poorer prognosis in AML with normal cytogenetics, however, NPM1 and CEBPA have shown to confer an improved prognosis in AML with normal cytogenetics.
  • Relapse: Long-term survival after a relapse is rare.

Keywords: acute myelogenous leukemia; acute myeloid leukemia diagnosis; acute myeloid leukemia life expectancy; acute myeloid leukemia medication; acute myeloid leukemia prognosis elderly; aml acute myeloid leukemia prognosis; aml leukemia; aml leukemia survival rate

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