Acute Myeloid Leukemia (AML) Doctor in Indore

🔬 What is Acute Myeloid Leukemia (AML)?

Acute Myeloid Leukemia (AML) is a rapidly spreading blood and bone marrow cancer with the body developing great numbers of abnormal myeloid cells (a form of white blood cell). These immature cells (identified as myeloblasts) build up in the bone marrow and affect the formation of normal blood cells (red cells, white cells, and platelets).

• “Acute” = Rapid progression.

• Myeloid = Affects cells of the myeloid lineage (granulocytes, monocytes, etc.).

• Leukemia = Cancer, white blood cells.

📊 Who is Affected by AML?

• The main one (average age on diagnosis: approximately 68 years).

• It is less prevalent in children, but it can happen.

• More prevalent in males than in females.

🧬 Common Types of AML

AML is categorized on the basis of the cell affected and the genetic mutations involved.

🔹 1. According to the WHO Classification (2022 updates):

• AML can be classified into various subtypes, and these are dependent on:

• Genetic abnormalities

• History of other disorders or treatments.

• Extent of differentiation of the leukemia cells

🔹 2. By Cytogenetics and Mutations:

Type Description Prognosis AML with t(8;21) Associated with RUNX1-RUNX1T1 gene fusion Favorable AML with inv(16) CBFB-MYH11 fusion Favorable AML with FLT3 mutation Common in younger patients Poor (without targeted therapy) AML with NPM1 mutation Often favorable Good (especially if FLT3-negative) AML with TP53 mutation or complex karyotype Often therapy-related Poor

🔹 3. Special Forms:

• Acute Promyelocytic Leukemia (APL) (M3 subtype):

• Translocation (PML-RARA fusion) t(15;17) causes.

• Medical emergency because of the risk of excessive bleeding.

• Showing response to ATRA + arsenic trioxide - high cure rate

⚠️ Symptoms of AML

The symptoms are caused by the substitution of normal blood cells with leukemic blasts and by the invasion of organs.

🩸 Due to Bone Marrow Failure:

• Anemia → Tiredness, lack of strength, difficulty breathing.

• Decreased white cells: Diarrhea, infections, etc.

• Low platelets→ Easy bruising, bleeding, petechiae.

🦴 Bone and Organ Symptoms:

• Bone pain or tenderness

• Puffy gums (particularly monocytic AML)

• Large liver, spleen, or lymph nodes (uncommon)

• Skin rash or leukemic infiltrates (leukemia cutis)

🧠 Rare CNS symptoms:

• Headache, confusion, vision issues (more typical of children or more advanced illness)

🔍 Risk Factors for AML

• AML typically occurs during genetic mutations, but there are multiple risk factors known to put people at risk:

✅ Established Risk Factors:

1. Age:

• Age (particularly over 60 years) is a risk factor.

2. Premediation Chemotherapy or Radiation:

• t-AML is a complication that occurs following therapy for other cancers (particularly those treated with alkylating agents or topoisomerase inhibitors).

3. Myelodysplasia Syndromes (MDS) or Other Blood Disorders:

• AML may develop out of an underlying MDS or myeloproliferative neoplasma (MPN).

4. Genetic Disorders:

• Down syndrome

• Fanconi anemia

• Bloom syndrome

• Li-Fraumeni syndrome

5. Chemical Exposure:

• Benzene

• Smoking ( raises the risk of AML 1.5-2x)

6. Family History:

• Some inherited mutations are rare but might be risk-increasing, such as CEBPA.

🛡️ Prevention of AML

AML cannot be prevented in a certain way, as there are numerous cases with no apparent causes. But there are risk minimization strategies:

🧴 Avoidable Risk Factors:

• Minim exposure to benzene (industrial chemicals, solvents).

• Quit smoking tobacco, known to be a risk factor.

• Minimize radiation exposure.

⚠️ Cancer Survivors:

• Chemotherapy and radiation used to treat other cancers should be closely monitored in patients.

🧬 Genetic Counseling:

• Early surveillance and detection can also be recommended in families with known genetic syndromes.