Acute Myeloid Leukemia

There are numerous subtypes of AML. Depending on what type of AML you have, you may experience different symptoms and respond better to certain treatments. AML often affects white blood cells (linked to your immune system), but it can also affect your red blood cells or platelets.

Many AML subtypes are defined by specific genetic mutations, in which there are abnormalities within your genes or chromosomes that help produce cancerous cells. Other types are defined by how the cancer cells mature and behave over time. In some cases, your cancer might be linked to an inherited gene or even to previous treatments for a different cancer that damaged your DNA. Your care team will perform tests to determine what kind of AML you have and what course of treatment might be most beneficial.⁶

Researchers are still working to understand the underlying causes of AML. Much of it has to do with your genes or chromosomes. If you develop or inherit a certain mutation or set of mutations, this can lead to the growth of cancerous blood cells.

AML intensifies quickly and can cause a range of symptoms. These symptoms often set in very rapidly and can include:

• Exhaustion
• Weakness
• Susceptibility to infection and swollen lymph nodes
• Fever and chills
• Unexplained bruising and bleeding (e.g., from your nose or gumline)
• Skin that is paler than normal or does not have its usual appearance
• Dizziness and headaches
• Shortness of breath
• Pain in your bones or torso
• Less commonly: a tumor made up of myeloid cells

There are no hard and fast rules about who may get AML. However, you may be more likely to get it if you have certain risk factors:

• Being over the age of 65 (over half of all people with AML)
• Being male
• Exposure to certain carcinogens, including smoking, formaldehyde and benzene
• High levels of radiation exposure
• Previous treatment for cancer, such as chemotherapy or radiation
• Certain genetic disorders such as Down syndrome
• Certain bone marrow diseases such myelodysplastic syndrome (abnormal bone marrow and decreased blood cells production), myelofibrosis (a slow-growing blood cancer), thrombocytosis (having a higher number of platelets) and aplastic anemia (in which your body doesn’t make enough blood cells)
• Having a family history of blood or bone marrow disorders, especially a close blood relative

It is possible to have none of these risk factors and still get AML.^{2 3 7}

Acute myeloid leukemia is a rare cancer. It makes up approximately 1% of all cancer diagnoses.⁸

If your doctor suspects you may have AML, they will likely run tests on your blood and bone marrow. This includes getting an accurate count of the different types of blood cells. They may order a biopsy of the bone marrow and perform testing for signs of changes to your DNA. More targeted testing can also help identify what type of leukemia you have.

Once your care team has determined you have AML, they will also determine if the cancer has spread outside of your bloodstream and bone marrow. AML does not have traditional staging (Stage I, Stage II), as many other types of cancer do. However, understanding if and where the cancer has spread can help determine the best course of treatment.¹

Left untreated, AML can rapidly become fatal, sometimes within weeks or months. Effective treatment is needed immediately after diagnosis. In addition to treatment, many factors play a role in your chance of going into remission (when there are no signs of AML in the body). Factors that may influence your prognosis include¹:

• Your age at diagnosis
• How high your white blood cell count is at diagnosis
• Whether the cancer has spread to your central nervous system
• Whether the cancer is being treated for the first time or has come back
• Which subtype of AML you have

Treatment for AML typically follows two phases: first, to kill the cancer cells within the bone marrow and in the blood and second, to kill any remaining cancer cells that could cause the cancer to come back.¹ Somewhere between 50% and 80% of people AML go into remission following initial treatment.²

Yes, AML commonly relapses after going into remission. About half of all people with AML will ultimately relapse.⁵ However, many factors, including the specific subtype of AML you have, will affect your risk of the cancer coming back.⁶ If your cancer does come back, there may be options beyond chemotherapy, including a stem cell transplant or participation in a clinical trial.²

AML is curable for some patients. If the cancer does not relapse within a few years of completing treatment, this is often a good indicator of lasting remission. However, it is still possible for the cancer to return. Some subtypes of AML are more likely to recur after a longer period of remission.¹

If you’ve been diagnosed with AML, it’s important to have support and take care of yourself. AML is scary, isolating and impacts many aspects of your daily life. If you achieve remission, the possibility of relapse remains a source of stress. Don’t be afraid to ask for help from your friends and family. A support group can provide a space to share experiences and discuss your feelings and anxieties.

You can also take time to learn more about AML, including your own subtype. This can help you feel more prepared to offer your own input onto your care and treatment decisions.^{2 3}

Researchers are continuously investigating potential new and more effective treatments. For guidance on the best treatment options for you—and to determine if you may qualify for a clinical trial—please speak with your healthcare provider.