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Aml: Symptoms, Causes, Diagnosis & Treatments

AML stands for Acute Myeloid Leukemia. It is a blood cancer which can affect children and adults. As the progression of the disease is very quick, there will be serious health issues. The prevalence of the disease is more common in men than women. Men over 50 years have more chances to be affected by the disease. There will be complete remission in 60% to 70% of adults with the treatment.

What is AML?

AML is a blood cell cancer which will develop very quickly. Acute leukaemia will start immediately and chronic leukaemia will take a long time for progression. With AML, the malignant disease will spread very quickly. There will be the presence of too many white blood cells in the body in the immature state. The useful cells will be destroyed very quickly when you suffer from acute leukaemia.

The production of abnormal cells will disturb the functionality and there will be crowding up of healthy cells. The exact cause of DNA mutation is not found. Chemotherapy is an effective treatment to overcome AML. However, there are two factors which will affect the prognosis. They are age and genetic traits.

Other names of Acute Myeloid Leukemia (AML)

  • Acute myelocytic leukaemia
  • Acute myelogenous leukaemia
  • Acute granulocytic leukaemia
  • Acute non-lymphocytic leukaemia

Symptoms of Aml

With AML, the development of signs and symptoms will be very gradual. However, the immature cells (blast cells) will take up more space in blood at a rapid rate.

The following symptoms are found in the patients suffering from AML:

  • High fever
  • Breathlessness
  • Number of infections in a short period of time
  • Fatigue
  • Confusion
  • Bruise of skin very easily
  • Swollen liver
  • Swollen lymph nodes
  • Swollen spleen
  • Pain in joints
  • Swollen spleen
  • Bleeding from nose or gums
  • Sudden weight loss
  • If the cells enter the central nervous system, there will be a headache, blurred vision, seizures, vomiting, and dizziness.
  • If the patient fails to undergo treatment for AML, it will turn into a life-threatening disease. Leukaemia can spread to the blood and various other parts of the body very quickly.
  • The risk of the disease is high in men over 65 years of age. AML is prevalent highly prevalent in men rather than women.
  • The risk will increase with people who were subjected to chemotherapy to treat other kinds of cancer or disease.
  • The risk will also increase if the people have the history of other blood disorders.
  • Certain kinds of genetic disorders such as drowns syndrome will increase the risk of AML.

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Causes of Aml

  • The bone marrow cells will turn into mutation cells and the exact cause is not known.
  • Exposure to radiation, benzene or both will increase the risk of leukaemia.
  • The risk to AML will increase with the exposure to radiation.
  • People exposed to nuclear radiation will pose a high risk of AML.
  • The radiation will take place through the nuclear accidents.
  • The radiation effect will also take place in pilots who work closer to the sun
  • If you are exposed to industrial solvents, you will be affected by benzene. It is part of the crude oil and gasoline.
  • The other reasons which can lead to AML include smoking, genetic conditions, and chemotherapy drugs.

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Diagnosis of Aml

  • You can diagnose the AML in various ways. if you find signs which are related to leukaemia, you should get a physician’s advice.
  • The patient should undergo a physical examination by the doctor. The doctor will examine eyes, mouth, skin, liver, spleen, lymph nodes and the nervous system.
  • The doctor will find out the family history of the patient to figure out the risks associated with the family.
  • Blood and bone marrow tests will be conducted if the doctor suspects leukaemia.
  • The bone marrow sample can be collected in different ways. Through the bone marrow aspiration method, liquid bone marrow fluid will be extracted by using a needle.
  • By using a large needle, the physician can remove a tiny piece of bone as well as marrow and it is called a biopsy.
  • By applying lumbar puncture, the spinal fluid will be extracted from the brain. The procedure will be performed if the doctor suspects the spread of disease to the brain.
  • Various kinds of blood tests will be conducted to find out the type of leukaemia.
  • The blood tests are done to find out the white blood cell count, peripheral blood smear and the shape of cells.
  • By undergoing the blood biochemistry and coagulation testing, it is possible to assess the liver and kidney issues.
  • The cytochemistry test will be done to find out the type of leukaemia. It will also help in the prognosis and the dye staining method will be applied.
  • The type of leukaemia will be identified with the cytometry and immunohistochemistry.
  • The genetic changes in few cells will be tracked through the polymerase chain reaction. The test can be done to track changes in a few cells.
  • The changes in small parts of chromosomes will be noticed with the Fluorescent in-situ hybridisation (FISH) test. These changes are not visible under the microscopic test.
  • The changes in chromosomes will be noticed through the cytogenetics.
  • Microscopic tests are used to figure out the appearance as well as blasts of white blood cells. The immature white blood cells in the body can be found. If the blood and marrow contain 20% blasts, the patient is eligible for the AML diagnosis.
  • The identification of specific genes and chromosome changes will be done very efficiently with the genomic testing. There are various issues which are unique to the white blood cells and they will be identified through the genomic testing. The test will help in the prognosis and there will be vital clues for the treatment.
  • After confirming the AML, you doctor should figure out the sub-type of AML. The extent of cancer will be identified with the test and the classification of AML will be done.
  • The characteristics of cells will be found by conducting special laboratory tests. After finding the subtype, the most appropriate treatment will be offered to the patient.

Prevention of Aml

  • As the risk factor for AML is high in smokers, you should avoid smoking and should maintain a healthy lifestyle.
  • You should not expose to certain kinds of chemicals such as benzene, cigarette smoke, paint strippers, cleaning solutions and detergents.
  • The risk will increase when certain kinds of chemotherapy medications are mixed with radiation therapy.
  • The exposure to high doses of radiation should be avoided
  • The diagnostic investigation should follow several months to several years after the treatment so that the recurrence will be ruled out.
  • The potential side effects of chemotherapy will be identified by the regular visits made by the patients as per the doctor’s advice.
  • As leukaemia is acute, it can spread very quickly. Hence, patients should undergo the treatment very quickly. If the treatment is neglected, it will quickly spread to the blood and other parts of the body such as lymph nodes, liver, spleen, brain, spinal cord and testicles.
  • The risk to AML varies from one person to another person. The risk factor will be low if you are younger than 60 years and maintain lower white blood cell count.
  • The risk to AML will be low if you do not have a history of blood cancer or disorders.
  • If you are not exposed to gene mutations or chromosome changes, the impact of AML will be low.

There is no way to prevent AML. However, you should avoid smoking and the exposure to chemicals should be avoided. The blood cells are made in the spongy tissue (bone marrow) inside the bones. The exact reason for the damage of blood cells is not figured out by doctors.

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Treatment of  Aml

  • Chemotherapy and radiation therapy are applied to overcome leukaemia.
  • Chemotherapy is the primary treatment for AML.
  • Radiation therapy is the most commonly used treatment option for AML.
  • Some patients will undergo bone marrow transplant.
  • There are two phases of treatment. They are induction and post-remission therapy. The remission therapy is also called as continuation therapy.
  • Chemotherapy drugs will be imparted on an intensive basis during the induction therapy. The drugs administered to the patient include idarubicin, daunorubicin, or mitoxantrone plus cytarabine and thioguanine. The drugs will help in the development of cells in their mature state and they will die later. It will also help in further division of cells.
  • The chemotherapy drugs will ensure the remission as they will destroy malignant cells. The treatment will be offered through the intravenous application (drip method). You can also take these pills in oral form.
  • If the patient is free from all signs, it will be concluded as complete remission. However, some cancer cells will persist in the body. And, the patient will go through the second phase of treatment.
  • Two-thirds of the patients who undergo chemotherapy will experience remission.
  • If there are leukemic cells after the standard chemotherapy, post-remission therapy will be implemented. In this process, very high doses of chemotherapy will be introduced on the body.
  • A combination of medicines will be used to treat the patient during the remission therapy. The medications include cyclophosphamide, idarubicin, etoposide, daunorubicin, mitoxantrone and cytarabine.

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Complications of Aml

  • The patient should undergo the treatment after the diagnosis. If the patient fails to undergo the treatment after the diagnosis, the life expectancy will be around 8 months.
  • There may be serious side effects after undergoing the chemotherapy.
  • The side effects include loss of hair, nausea, diarrhoea, and severe infections.
  • To manage the side effects, the patient should be admitted to the hospital for intensive care.
  • The patient’s immune system will be very weak during the active stage of the disease and during the remission stage. The condition is considered as an immunocompromised stage.
  • As the patient’s immune system is very weak, they will develop complications very easily.
  • Chemotherapy, as well as antibiotics, will be prescribed by the physician to overcome or manage infections.
  • If a patient gets AML after the chemotherapy, it is known as recurrence.
  • The recurrence of AML may take place during or after the treatment. If it is traced after the treatment, the duration will be very short.

Myths about Aml

Myth #1: AML may recur after a long time

AML may recur in the body after a short time after the treatment. However, it is rare to recur after a long period of time.

Myth #2: AML will start anywhere in the body

AML will start in the bone marrow. The bone marrow is the soft inner part of the bone. When a person is affected with AML, the bone marrow cells will not mature as they should. The immature cells which are also called as blast cells will increase at a rapid rate.

Myth #3: AML progresses slowly

As the term acute indicates, the progression of AML will be very quick.

Myth #4: Signs mimic flu

The general signs and symptoms of AML will be similar to flu or other common diseases. The signs and symptoms will vary based on the blood cells affected which are affected by the disease.

Myth #5: There will not be damage to the DNA

There will be damage to the DNA of developing cells. The production of blood cells will go in the wrong direction. The production of immature blood cells will lead to leukemic white blood cells.

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Conclusion

Acute Myeloid Leukemia is a blood cancer which turns cells into white blood cells. The AML will also form other types of blood cells. There is no cure for AML. However, the treatment such as chemotherapy and radiation therapy will make a difference. The patient’s life expectancy can be increased by managing the condition in a very efficient manner. The cooperation of the patient as well as the expertise of the physician will play a crucial role in managing the condition.

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Last updated on : 24-12-2018

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