Penn pioneered the clinical trial using autologous transplant for acute myeloid leukemia (AML). This innovation led to national trials which resulted in the use of autologous transplant as the standard of care for AML.
We also have one of the few hematologic malignancy research programs — dedicated to leukemia, lymphoma and multiple myeloma — in the country that is approved and funded by the National Cancer Institute.
What is Acute Myeloid Leukemia (AML)?
Acute myeloid leukemia is when the healthy bone marrow is overtaken by blasts that, under normal cell development, would have become (non-lymphoid) white blood cells, red blood cells or platelets.
Leukemia is a blood cancer of the bone marrow, which is the organ responsible for blood cell development. In patients with AML and other types of leukemia, immature cells called blasts overtake their healthy bone marrow. Acute leukemia is considered lymphoid or myeloid based on the type of blood cell that is involved.
Acute myeloid leukemia accounts for 80 percent of adult leukemia. There are approximately 11,000 new cases of AML diagnosed every year in the United States.
Acute myeloid leukemia may also be referred to as acute myelogenous leukemia, acute myelocytic leukemia, acute myeloblastic leukemia or acute granulocytic leukemia.
AML Symptoms and Signs
Signs and symptoms of AML may look like other signs and symptoms of diseases or conditions. If you have any, some, or all of these symptoms,* please speak with your physician:
- Body aches
- Bruising easily, or not remembering how you got a bruise
- Fever without a reason, or a low-grade fever
- Headaches
- Pale skin
- Pinhead-sized red spots under the skin
- Excessive bleeding from minor cuts
- Swollen gums
- Shortness of breath
- Tiredness, lethargy
- Night sweats
- Unexplained weight loss / loss of appetite
- Enlarged spleen or liver (upon physician examination)
*From the Leukemia and Lymphoma Society
Acute Promyelocytic Leukemia (APL)
An example of an AML subtype is acute promyelocytic leukemia, or APL. Patients with APL have a specific chromosomal abnormality that affects the way their body handles a chemical in the body called retinoic acid. Retinoic acid is involved in cell maturation. In other words, in people with APL, cells are not able to mature properly.
If this chromosomal abnormality is detected, people with APL receive a medication which is a derivative of Vitamin A in order to improve outcomes of standard therapy. What was once one of the most fatal forms of leukemia is now one of the most curable thanks to personalized diagnostics and treatment.
Acute Myeloid Leukemia Risk Factors
Risk factors can increase the chance of getting cancer. There are different kinds of risk factors. Some risk factors for cancer, like age and family history, cannot be prevented. Currently, the only known risk factors for acute myeloid leukemia (AML) are:
- Prior chemotherapy and/or radiation therapy
- Repeated exposure to benzene
- Certain genetic disorders
- A history of other blood cancers
If you are concerned about your risk for developing leukemia, speak with your physician.
How Is Acute Myeloid Leukemia Diagnosed?
Getting an accurate acute myeloid leukemia (AML) diagnosis, and identifying its subtype is extremely important in determining the treatment for your AML. This is because different subtypes of AML respond to different drugs and treatment therapies. Also, depending on your prognosis, different therapies may be used and recommended.
If you were diagnosed through another health care center's leukemia diagnosis, and are coming to the Abramson Cancer Center for treatment or a second opinion, repeat diagnostic tests may be necessary. This is because here, we have access to the latest diagnostic imaging tools, tests and procedures to navigate your personalized treatment plan:
- A physical exam and full medical history evaluation
- A complete blood count (CBC)
- Blood chemistry studies
- Peripheral blood smear
- A bone marrow aspiration and biopsy
- Genetic studies through the Center for Personalized Medicine
In addition, Penn's hematology and hematopathology labs provide routine hematologic tests, specialized tests that diagnose and classify AML subtypes, and evaluation of lymphoid tissue biopsies. These labs provide even more specialized diagnostics for people with AML.
Staging AML
Staging is a way of describing cancer: where it is located, if or where it has spread, and if it is affecting the functions of other organs in the body.
Leukemia is not staged; rather, it is classified into subtypes using one of the following classification systems that are based on the way the cells look and the results of chromosome and gene testing:
- French American British (FAB) classification system
- World Health Organization classification system
AML Treatment Options
Penn hematologists and medical oncologists are part of large multidisciplinary teams whose approach to treating leukemia and blood disorders is to treat the entire individual, not just the disease.
If you have been diagnosed with AML, you may undergo remission induction therapy. People with AML are considered to be in remission if their bone marrow has no evidence of disease and their bone marrow and blood cell counts have returned to normal.
To treat AML, you may be admitted to the hospital for some time to receive therapy. Many leukemia treatments kill rapidly dividing cells, which means that both normal and abnormal cells are killed. Because of this type of therapy, you are at a very high risk for infections, and must remain in the hospital.
Once you are in remission, your doctor may recommend additional chemotherapy and/or a bone marrow or stem cell transplant to prevent you from relapse.
The following are possible treatments for people diagnosed with acute myeloid leukemia (AML). Your treatment will depend on the subtype of your AML and its prognosis.
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