Acute Myeloblastic Leukemia is a rare, fast growing and serious cancer of the blood. This disease involves the over production of cells in bone marrow that are supposed to mature into white blood cells. White blood cells are known as granulocytes. Myeloid refers to bone marrow cells that are non-lymphatic, specifically designed to mature into white blood cells called granulocytes and monocytes; and platelets. In acute Myeloblastic leukemia it is the cells designed to be granulocytes and monocytes, used in by the immune system, that do not mature. The immature cells are called blasts. This disease affects between four and six children per million per year. Other names that this disease is referred to as, are: Acute Myeloblastic Leukemia with maturation, AML – M2 (FAB classification), Acute myeloid leukemia with t(8;21), (q22;q22), (AML1/ETO) translocation (a World Health Organization classification) and acute non-lymphocytic leukemia ANLL.
|Acute Myeloblastic Leukemia
Symptoms for Acute Myeloblastic Leukemia are:
• Weakness, lack of typical strength
• Fatigue, over-tiredness
• Persistent fever
• Severe infections
• Frequent and unusual bruising
• Pallor possibly accompanied by dizziness, tinnitus, congestive heart failure
• Vomiting, headache, nausea
Clotting and bleeding disorders account for seven to ten percent of the deaths of patients with AML within weeks after diagnosis.
Diagnosis for acute Myeloblastic leukemia is determined by blood work, bone marrow biopsy, cerebral spinal fluid examination and chest x-ray.
Cytometry, cytogenetics and immunohistochemistry are three other tests that are used to analyze the leukemia cells. The cytometry passes the cells through a laser beam. The immunohistochemistry uses antibodies to determine the types of leukemia cells involved. Cytogenetics analyzes the leukemia cells for chromosomal changes. Molecular genetic studies test the DNA and RNA of the leukemia cells.
Induction therapy is the first phase of treatment for AML. The purpose of this phase is to kill as many leukemia cells as possible and put the patient in remission. Remission is a state in which there is no visible evidence of the disease and blood counts are normal. During induction therapy patients may receive a combination of drugs during this phase including daunorubicin, idarubicin, or mitoxantrone plus cytarabine and thioguanine. Once in remission with no signs of leukemia, patients enter a second phase of treatment.
The second phase of treatment is called post-remission therapy (or continuation therapy). It is designed to kill any remaining leukemic cells. In post-remission therapy, patients may receive high doses of chemotherapy, designed to eliminate any remaining leukemic cells. Treatment may include a combination of cytarabine, daunorubicin, idarubicin, etoposide, cyclophosphamide, mitoxantrone, or cytarabine.
There are a few different subtypes of acute Myeloblastic leukemia. The classification is based on the FAB or French American British system. The subtypes of AML are grouped according to cell in which the disease first began to develop. There eight distinct types of AML designated by M0 through M7.
M2 and M4 are also known as Myeloblastic leukemia with maturation and myelomonocytic leukemia respectively. They each account for twenty-five percent of all acute Myeloblastic leukemias. Myeloblastic leukemia (M1) with little or few cells accounts for fifteen percent. Promyelocytic leukemia (M3) and Monocytic leukemia (M5) each account for ten percent of all acute Myeloblastic leukemias. Types M0, M4, M6, and M7 are rarely seen. Acute Myeloblastic leukemia is also classified by the malignant cells’ chromosomal mutations.
Treatment for acute promyelocytic leukemia – APL is different from the other forms of acute Myeloblastic leukemia – beginning with ATRA or all-trans-retinoic acid. This treatment results in a complete positive response of seventy percent of cases, extending survival. The next phase of treatment is a consolidation therapy which usually includes Ara-C (cytosine arabinoside and idarubicin.
Bone marrow transplant is another form of treatment. A better chance of recover is seen in hospitals that perform more than five transplants per year. Bone marrow transplant replaces the patient’s leukemic bone marrow with healthy bone marrow. After the best match is found for a patient, all bone marrow is destroyed in the patient, using high doses of chemotherapy with possible radiation therapy. Healthy marrow can be given to the patient via and intravenous line.
The chance of overall recovery from AML depends on the type of leukemia, the health of the patient and the patient’s age.
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Corticosteroids like Methylprednisolone are used to provide relief for inflamed areas of the body. They lessen swelling, redness, itching, and allergic reactions. They are also often used for severe allergies or skin problems, asthma, or arthritis.
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