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Acute Myeloid Leukemia (AML)

About Leukemia

Leukemia is a type of cancer that affects the body's white blood cells (WBCs).

Normally, WBCs help fight infection and protect the body against disease. But in leukemia, WBCs turn cancerous and multiply when they shouldn't, resulting in too many abnormal WBCs, which then interfere with the body's ability to function normally.

In acute myeloid leukemia (AML), too many immature white blood cells (called myeloid blasts) are made. These leukemia cells are abnormal and cannot mature into normal white blood cells. This type of leukemia affects 20% of kids with this cancer of the blood cells.

Thanks to advances in therapy and clinical trials, the outlook for kids with AML is promising. With treatment, most are cured.

Causes

The cause of AML is unknown, though doctors know that certain medical conditions can increase a child's risk of getting AML. However, just because a child has a risk factor does not mean that he or she will get AML.

Risks include inherited genetic problems such as Down syndrome, neurofibromatosis type 1, Fanconi anemia, Noonan syndrome, and other inherited bone marrow failure syndromes (IBMFS). In addition, other non-inherited conditions such as preleukemia (also called myelodysplastic syndrome or MDS) and aplastic anemia can increase the risk of AML.

AML is also more common in kids who've been treated with chemotherapy or radiation. In fact, AML is the most common type of secondary cancer in children who have previously undergone cancer treatment.

In addition, a child with an identical twin who was diagnosed with leukemia before age 6 has a 20% to 25% chance of developing AML. Fraternal twins and other siblings of kids with leukemia have two to four times the average risk of developing it, too.

Certain environmental factors can predispose a child to leukemia. For example, exposure to radiation (such as X-rays) prior to birth may trigger the disease in a developing fetus.

Signs and Symptoms

AML is called "acute" because it tends to worsen quickly if left untreated. Chronic blood cancers, like chronic myelogenous leukemia (CML), tend to progress more slowly. However, the symptoms of all types of leukemia are generally the same and include:

Sometimes a child might have painless lumps that can be felt in the lymph nodes of the neck, underarm, or groin area. These lumps of leukemia cells (called chloromas) can develop anywhere in the body.

Diagnosis

The subtypes of AML are classified according to the way the cells look under a microscope. If a doctor suspects leukemia, a child may undergo tests that include:

Treatment

Because it can progress so quickly, there is no staging system for AML. Doctors generally characterize the disease as newly diagnosed or in remission.

Treatment is divided into two phases. The goal of the first phase, called induction, is to kill as many cancer cells as possible and achieve remission (a state where there is no evidence of disease in the body). The second phase (called post-remission, consolidation, or continuation therapy) is designed to eliminate any undetectable leukemia cells.

Phases I and II of treatment may include the following therapies alone or in combination:

Coping

Being told that a child has cancer can be a terrifying experience, and the stress of cancer treatment can be overwhelming for any family.

Although you might feel like it at times, you're not alone. To find out about support that may be helpful to you or your child, talk to your doctor or a hospital social worker. Many resources are available to help you get through this difficult time.

Reviewed by: Emi H. Caywood, MD
Date reviewed: March 2012

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Note: All information is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.
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