Your AML diagnosis: what does it mean?

Find out what Acute Myeloid Leukemia (AML) is, and what your diagnosis means in terms of symptoms, possible therapies, and everyday challenges.

Myeloblasts graphic

What is AML?1,2

AML is a type of leukemia that originates in the bone marrow and blood. Healthy bone marrow produces many cell types, such as red blood cells, white blood cells, and platelets. These cells are all called myeloid cells and are essential for transporting oxygen, helping fight infections, and assisting in blood clotting.

AML typically occurs when the stem cells that help produce these types of myeloid cells cannot fully develop. These immature myeloid cells are called myeloblasts and are unable to grow to become mature, healthy cells. The myeloblasts can crowd out healthy, functional cells in blood and bone marrow, causing the symptoms of AML to occur.

“Acute” in the name Acute Myeloid Leukemia (AML) means that disease can progress quickly if left untreated.

AML subtypes2

Because AML does not typically form solid tumors, patient outlook is not based on tumor size and spread but often based on information such as AML subtypes. AML can have one of several subtypes, based on characteristics of the cancer cells and how they differ from normal cells. Knowing your subtype (determined by lab tests) can affect prognosis and treatment.

The World Health Organization (WHO) classifies AML subtypes based on recurrent genetic abnormalities or how mature the cells appear. Working with your doctor, you can identify your AML subtype and how it may impact your treatment.

AML risk factors1

Most AML cases don’t have obvious causes or reasons for the development of the condition,
and it’s not contagious. However, these factors are associated with increased risk for AML:

AGE
AML risk increases as you get older.

SEX
AML is more likely in males than females.

LONG-TERM CHEMICAL EXPOSURE
Dangerous chemicals such as benzene increase the risk for AML.

SMOKING
Chemicals in tobacco smoke are associated with AML.

PREVIOUS CANCER TREATMENT
Radiation therapy or chemotherapy can increase the risk of treatment- or therapy-related AML.

HIGH-DOSE RADIATION
Extreme exposure increases AML risk.

OTHER BLOOD CANCERS
Some other blood disorders can turn into AML.

GENETIC DISORDERS
Some conditions that exist from birth increase AML risk.

INHERITED RISK
Gene mutations inherited from a parent can also increase AML risk.

AML signs and symptoms3

Symptoms from low red blood cell counts (anemia)
  • Fatigue
  • Weakness
  • Shortness of breath during normal physical activities
  • Dizziness, faintness, lightheadedness
  • Headaches
  • Pale complexion
Symptoms from low white blood cell counts (neutropenia)
  • Frequent infections
  • Fever
Symptoms from low platelet counts (thrombocytopenia)
  • Easy bruising
  • Petechiae: pinhead-sized red spots on skin
  • Prolonged bleeding from minor cuts
  • Severe or frequent nosebleeds
  • Bleeding gums
Other general AML symptoms
  • Feeling unwell from underproduction of normal bone marrow cells
  • Loss of appetite
  • Weight loss
  • Bone and joint discomfort
  • Abdominal fullness or swelling from an enlarged spleen or liver
  • Blurred vision or loss of vision

How AML is diagnosed5

Several types of blood and bone marrow tests are used to diagnose AML and specific subtypes.
These tests look at the number, appearance, and genetics of blood cells.

BLOOD TESTS
A complete blood count (CBC) counts the number of cells of each type, and peripheral blood smears check the number, shape, and size of cells for leukemia.

CELL EVALUATION
A blood specialist examines blood and bone marrow samples under a microscope and performs other tests.

MOLECULAR TESTS
A variety of tests are used to examine a patient’s chromosomes and genes.

BONE MARROW TESTS
Usually taken from the hip, these tests check samples for chromosomal and other changes.

CELL COMPARISON (IMMUNOPHENOTYPING)
Cancer cells and normal cells are compared using specialized instruments.

PRE-TREATMENT TESTS
Other tests are used to assess overall health before treatment begins.

Types of AML treatments2

Following diagnosis and the identification of a particular subtype, your healthcare team will help you decide on the best course of treatment. These are the 4 major types of AML treatment:

Expand each section below to see treatments your team may propose
Chemotherapy involves using one or more drugs to kill cancer cells or prevent them from dividing. It can destroy both cancer cells and healthy cells. These drugs can be taken orally or intravenously to reach cancer cells throughout the body via the bloodstream or can be injected directly into the part of the body that is affected, as is the case when AML has spread to the spinal cord or brain.
High-energy, external radiation is used to kill cancer cells or stop them from dividing. In AML, total-body, external irradiation is often used after a relapse, in preparation for a stem cell transplant.
Because chemotherapy and radiation therapy kill both healthy and cancerous cells, a stem cell transplant may be performed after these treatments to grow new blood-forming cells. Before chemotherapy or radiation starts, stem cells from the patient or a donor are removed, frozen, and stored. Then, after the patient completes chemotherapy or radiation, the stored cells are infused into the patient to regrow and restore healthy blood cells.

In cancer, precision medicine uses information about a patient’s own cells, genes or proteins to help plan treatment specific to any patient genetic abnormalities. One example is immunotherapy, treatments made from immune cells to train a person’s immune system cells to fight cancer. Another is targeted therapy, treatments that are designed to interfere with cancer causing genes or molecules.

Targeted therapy: when a specific genetic mutation is present, prescription drugs or immune system antibodies are used to find and attack cancer cells that have the mutation and work to block their growth and spread. Find out more about genetic mutations and targeted therapies.

AML treatment is typically a two-phase process:2

Phase 1: Remission induction therapy

In this phase, the goal is to use chemotherapy to kill as many leukemia cells as possible, putting
AML into remission.

Phase 2: Post-remission therapy

In phase 2, more chemotherapy is given and possibly a stem cell transplant to try to destroy any remaining leukemia cells and help prevent a relapse.

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References
1. Acute Myeloid Leukemia (AML). Leukemia and Lymphoma Society.
https://www.lls.org/leukemia/acute-myeloid-leukemia. Accessed February 13, 2023.
2. Acute Myeloid Leukemia Treatment (PDQ®)-Patient Version. National Cancer Institute at the National Institutes of Health.
https://www.cancer.gov/types/leukemia/patient/adult-aml-treatment-pdq#_1. Updated August 19, 2022. Accessed February 13, 2023.
3. Signs and Symptoms (AML). Leukemia and Lymphoma Society.
https://www.lls.org/leukemia/acute-myeloid-leukemia/signs-and-symptoms. Accessed February 13, 2023.
4. American Cancer Society. Signs and Symptoms of Acute Myeloid Leukemia (AML).
https://www.cancer.org/cancer/types/acute-myeloid-leukemia/detection-diagnosis-staging/signs-symptoms.html. Updated August 21, 2018
5. Diagnosis (AML). Leukemia and Lymphoma Society.
https://www.lls.org/leukemia/acute-myeloid-leukemia/diagnosis. Accessed February 13, 2023.
6. National Cancer Institute, Precision Medicine.
https://www.cancer.gov/publications/dictionaries/cancer-terms/def/precision-medicine.
7. American Cancer Society. Immunotherapy.
https://www.cancer.org/cancer/managing-cancer/treatment-types/immunotherapy.html. Accessed January 15, 2024
8. American Cancer Society. How Targeted Therapies Are Used to Treat Cancer.
https://www.cancer.org/cancer/managing-cancer/treatment-types/targeted-therapy/what-is.html. Accessed January 15, 2024.
9. American Cancer Society. Targeted Therapy Drugs for Acute Myeloid Leukemia (AML).
https://www.cancer.org/cancer/types/acute-myeloid-leukemia/treating/targeted-therapy.html. Accessed January 15, 2024.