Acute myelogenous leukemia
From ChildWiki.com
The AML disease is a blood and bone marrow cancer. AML is one of the four types of leukemia, that evolves rapidly and affects a group of white cells called the myeloid cells. Normally, these cells evolve and turn into mature blood cells. This leukemia type is also called acute myeloid leukemia, acute granulocyte leukemia or acute non-lymphocytic leukemia.
Under normal circumstances, the bone marrow will produce stem cells, that grow and specialize, and eventually get replaced by new young cells. In case of leukemia, the immature cells remain immature and they will stop the production of healthy cells capable of maturing. They leave the body open to infections, anemia and hemorrhages. The leukemic cells can move to various locations inside the patient's body.
The acute myelogenous leukemia is the most common leukemia type. The disease progresses rapidly if it is not treated, but it will respond to a proper leukemia treatment initially. Unfortunately, lots of AML patients encounter a recidivism. Researches are axed onto a reduction of the cancer relapse occurrence and obtaining positive results onto the long term in patients with AML.
The acute myelogenous leukemia is rare in children (about 20% of patients are toddlers and teens), but is is very common with adults.
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[edit] AML Causes
The main cause of the acute myelogenous leukemia is the damage that the DNA produces onto the bone marrow. Under normal circumstances, DNA can be compared with a set of instructions that settles both the time and the way in which cell get produces, grow and divide. Some DNA genes can trigger a faster cell division while others determine cellular destruction when the time is appropriate.
If one of the respective genes if activated, or the other one deactivated, the leukemia occurs. Immature cells are constantly produced and there is no gene to destroy them.
AML can also evolve from another blood disease or from chronic leukemia (CML), or other conditions that can determine the excessive production of cells by the bone marrow.
[edit] AML Treatment
Treatment is mainly based on chemotherapy, which will successively imply an induction stage, then a consolidation stage, and even an intensifying stage characterized by a bone marrow transplantation or stem cells transplantation procedure in young patients that have acquired a complete cancer remission.
The prognosis depends especially on age, the cytological type of cells, the present chromosomal abnormalities, any preexistent disease of the bone marrow and of course, on the response to the used treatment.
[edit] Inducing Remission
The purpose of this stage is that of destroying the leukemic cells from the blood and from the bone marrow. Still, the induction of the remission does not destroy all leukemia- related cells, so additional treatment methods are needed to prevent an eventual relapse.
[edit] Consolidation Therapy
Also called the post-remission therapy, the maintaining or intensifying stage, this part of the treatment is aimed at the destruction of all leukemia cells that are left in the body. It is considered as an essential stage in decreasing relapse risks.
This type of leukemia requires a rather aggressive chemotherapy. If leukemia persists even after one or more remission periods, a bone marrow graft will be used. The patient will receive a bone marrow transplantation from a patient with healthy bone marrow, a compatible donor. If finding a compatible donor is not possible, an auto transplant can be used, by taking a sample of the marrow from a part of the patient's body after the leukemia cells have been destroyed from that location.
This particular method permits obtaining prolonged remissions in many child's leukemias and in some adult leukemia types as well.
[edit] AML Signs and Symptoms
The common signs and symptoms of the early stages in acute myelogenous leukemia are very much alike those of a common flu:
- Weight loss
- Bone pain
- Weakness and tiredness
Specific AML signs are linked to the deficiency of functional blood cells, and they depend on the type of cells affected.
AML can also be held responsible for bleeding gums, abnormal menstruation, enlarged spline and liver. The lymph glands( better known as the lymph nodes) can be swollen as well. If the dissemination happens at the level of the central nervous system or in other organs, it will cause headaches, weakness, vomiting, dizziness and vision disorders.
[edit] AML diagnose
An early and correct leukemia diagnose and the corresponding leukemia treatment is very important for the life expectation of the patient.
In most cases, the diagnose is suspected in a routine blood test, when the blood cells are counted, and they show a higher number of white blood cells or too many abnormal young cells, or very few leukocytes. The diagnose can only be confirmed with an exam of the bone marrow.
- The blood test - will show a high number of white cells, next to the decrease in numbers of the red cells. If blasts are present, cells that are not mature and that usually exist in the bone marrow and not in the current blood, the the diagnose of AML is confirmed.
- The bone marrow test - is an exam used to confirm the leukemia diagnose. A bone marrow sample will be harvested from the lower region of the spinal cord, with a special needle.
- The lumbar puncture - in some cases, the collection of a sample of spinal liquid is required to detect leukemia cells.
All harvested samples will be analyzed under a microscope, and the blood cells are classified depending on size, dimensions and other characteristics. Thus, the type and subtype of leukemia is determined.
The AML types are classified in 8 subtypes, depending on the maturing degree of the cancer cells when the diagnose is established, and on the amount of differences they show from normal cells.
Establishing a correct subtype is important in choosing the optimal leukemia treatment.
