Acute Myeloid Leukemia (AML) is a type of blood cancer that affects blood and bone marrow. It primarily affects the myeloid cell line, which is responsible for producing red blood cells, platelets, and most white blood cells (except lymphocytes). In AML, the cells don’t grow into healthy blood cells. Instead, abnormal cells build up and stop the body from making normal blood.

It is also referred to by various names, including acute myelocytic leukemia, acute myelogenous leukemia, acute granulocytic leukemia, and acute non-lymphocytic leukemia.

Acute Myeloid Leukemia (AML) is one of the most common forms of blood cancer affecting adults, especially those over the age of 60. Due to its rapid progression, early diagnosis and immediate treatment are crucial for improving patient outcomes.

Types of Acute Myeloid Leukemia

Acute myeloid leukemia is divided into four subtypes based on the cell type affected. Each type has different symptoms and responds differently to different treatments. 

Listed are the AML subtypes:

• Myeloid Leukemia: A commonly occurring type of AML, which affects the myeloid cells that differentiate into neutrophils (white blood cells).
• Acute monocytic leukemia: It’s also known as AML-M5. It occurs in myeloid cells that are determined to develop into monocytes (white blood cells).
• Acute megakaryocytic leukemia: Occurs in cells that normally form red blood cells or platelets.
• Acute promyelocytic leukemia: Also called M3 leukemia, this subtype arises when immature white blood cells called promyelocytes grow uncontrollably, eventually overcrowding healthy blood cells in the bone marrow.

Symptoms

Initially, you may not have any major symptoms except a cold or flu, which won’t go away easily. However, acute myeloid leukemia grows aggressively; therefore, as the condition worsens, you may notice the following symptoms:

• Fatigue or weakness
• Fever or frequent infections
• Unexplained weight loss
• Loss of appetite
• Night sweats
• Pale or sallow skin
• Shortness of breath
• Easy bruising or bleeding
• Frequent or severe nosebleeds
• Bleeding gums
• Tiny red spots on the skin (petechiae)
• Bone or joint pain
• Swollen lymph nodes
• Enlarged liver or spleen
• Headaches
• Blurred vision
• Dizziness
• Seizures
• Patches or nodules on the skin (leukemia cutis)
• Rashes or skin discoloration

Causes

Currently, the exact cause of acute myeloid leukemia is unknown. However, AML occurs when mutations occur in the DNA of the bone marrow cells. The mutation causes the production of abnormal cells,  called myeloblasts. This doesn’t function properly, thus leading to the crowding out of healthy cells due to uncontrolled abnormal growth. 

Risk Factors

Several risk factors may contribute to the development of Acute Myeloid Leukemia (AML), including:

• Age: Mostly adults, people older than 65 are diagnosed with AML; although children may also be affected. 
• Smoking: A person who smokes cigarettes, which contain benzene or cancer-causing substances, is at higher risk. 
• Prior cancer treatment: If a person has undergone prior radiation or chemotherapy, then the person is at greater risk of developing AML. 
• Radiation or harmful chemical exposure: Exposure to harmful radiation or carcinogenic substances may increase your chance of developing AML.
• Other blood disorders: If you are dealing with disorders like polycythemia vera, myelodysplasia, myelofibrosis, or thrombocythemia, you may be at higher risk.
• Genetic disorders: Some of the genetic disorders, like Down syndrome, are more prone to cause AML.
• Family history: If someone in your family, like grandparents, parents, or siblings, has a blood or bone marrow disorder, then you are more likely to develop AML.

Complications

Initially, the number of normal red blood cells, white blood cells, and platelets reduces due to the overcrowding of the abnormal cells. However, this may also lead to other conditions, such as anemia, thrombocytopenia, and pancytopenia. 

Diagnosis of Acute Myeloid Leukemia

To diagnose AML, one or more tests may be recommended by your doctor, including genetic testing. Your doctor will begin with a physical examination to check for signs such as bruising, bleeding, infections, or swelling in the liver, spleen, or lymph nodes.

The following are the AML diagnostic tests that your doctor may advise:

• Complete Blood Cell Count: Through this test, the total number of red blood cells, white blood cells, platelets, and the amount of hemoglobin or hematocrit in the blood are determined.
• Peripheral Blood Smear: From the blood sample, the number of blood cells and their morphological changes are checked. Also, if there are any blast cells in your blood.
• Bone Marrow Biopsy: A sample of tissue is taken from the bone marrow through a thin needle to examine for any sign of cancer. 
• Lumbar Puncture: Also known as a spinal tap. A sample of fluid is taken from the brain and spinal cord to check if cancer has spread to those parts as well.
• Imaging Tests: Imaging tests such as CT scan, MRI, and PET scan are used to see if cancer has spread to another part of the body. 
• Cytogenetic analysis: Certain genetic tests are used to identify the AML type. This includes,
• • Flow cytometry:  To analyze the physical and chemical characteristics of cells or particles in a fluid.
  • Karyotype: This test examines the number and structure of chromosomes in cells to identify genetic abnormalities that may be linked to AML.
  • Fluorescence-in-situ-hybridisation (FISH): Uses fluorescent probes to detect and visualize specific DNA sequences on chromosomes, helping to identify gene changes associated with leukemia.
  • Immunohistochemistry: Detect specific antigens in tissue sections using labelled antibodies

If you are diagnosed with AML, your doctor advises you to undergo treatment as early as possible to reduce complications and improve outcomes. 

Treatment Options

Acute myelogenous leukemia treatment depends upon various factors such as AML subtypes, age, overall health condition, and prognosis. However, for both adults and children, the treatment options are the same.

The primary goal of treatment is to achieve complete remission, which means no cancerous cells can be detected through a microscope or any available tests. During remission, your blood count will also become normal.

Treatment for Acute Myeloid Leukemia (AML) typically has two main phases:

• Remission Induction Therapy:  To destroy leukemia cells in the blood and bone marrow to achieve remission.
• Consolidation Therapy (post-remission or maintenance therapy): To target any remaining leukemia cells. It’s also essential to reduce the risk of relapse and ensure long-term remission.

The following are the types of treatments available for acute myeloid leukemia:

• Chemotherapy: A commonly used treatment in which powerful drugs are used to destroy the cancerous cells. This is usually provided in cycles and is often the first step in remission induction.
  
• Targeted Therapy: Medications are used that can specifically block the action of abnormal proteins or genes in cancer cells. Targeted therapies are more precise and often have fewer side effects than traditional chemotherapy.
• Stem Cell Transplant: This procedure replaces diseased bone marrow with healthy stem cells, often after high-dose chemotherapy or radiation. It’s typically considered for patients at high risk of relapse or those who have relapsed after initial treatment.

Recovery from AML varies depending on the patient’s age, health, and response to treatment. Many patients achieve complete remission, and ongoing follow-ups help monitor for relapse or side effects.

Also Read:- Acute Myeloid Leukemia Treatment Cost in India

Complications of Treatment

Although not unique to Acute Myeloid Leukemia (AML), all cancer treatments can cause side effects, ranging from mild to severe. Below are some common complications that may occur during AML treatment.

• Weakened immune system
• Liver, kidney, or heart function issues
• Nerve damage (neuropathy) – tingling or numbness
• Hair loss and loss of appetite
• Graft-versus-host disease (in stem cell transplant cases)
• Risk of secondary cancers (in rare cases) 

However, this shouldn’t be a cause for fear—many of these complications are manageable, and with time, your condition can improve.

Prognosis of Acute Myeloid Leukemia

The prognosis of AML depends on factors such as age, overall health, genetic mutations, and response to treatment. Due to modern therapies, most patients are seeing improvement in outcomes.

Although there are two sides to the acute myeloid leukemia prognoses. On the one hand, about

50-80% of patients achieve complete remission after treatment, which may last for months or years. Moreover, a complete remission occurs in children and adults under age 60.

On the other hand, relapse remains a concern. Nearly 50% of those who achieve remission may experience a recurrence of AML. And when this happens, your doctor may advise you to undergo additional chemotherapy or stem cell therapy.

Prevention

Acute Myeloid Leukemia (AML) cannot be fully prevented, as it often develops due to genetic changes in the bone marrow. However, because the exact triggers of these changes are not well understood, certain precautions may help reduce the overall risk:

• Avoid exposure to known carcinogens, such as benzene and harmful chemicals
  
• Quit smoking, as tobacco has been linked to several types of cancers, including leukemia
  
• Manage underlying health issues like chronic blood disorders early
  
• Maintain regular medical check-ups, especially if there’s a family history or other risk factors

While these measures don’t guarantee prevention, they support early detection and contribute to better long-term health outcomes. 

How is Acute Myeloid Leukemia Different from Other Leukemias?

All leukemias are different in their own ways, but here’s what makes AML stand out from the rest:

• Rapid progression: AML is an aggressive (acute) form of leukemia that advances quickly and needs immediate treatment.
  
• Origin: It affects myeloid cells, which are responsible for producing red blood cells, white cells (except lymphocytes), and platelets.
  
• Age group: AML is more common in adults, particularly older adults, while other leukemias, such as ALL (Acute Lymphoblastic Leukemia), are more common in children.
  
• Treatment approach: AML usually requires intensive chemotherapy and may involve stem cell transplantation, whereas some chronic leukemias may be managed over time with less intensive treatments.

Takeaways

Acute Myeloid Leukemia (AML) is a fast-progressing blood and bone marrow cancer that can affect anyone, especially older adults. While its exact cause is unknown, early diagnosis and timely treatment can lead to complete remission. With advanced therapies currently available, outcomes and survival rates continue to improve.