In acute myeloid leukemia white blood cells known as granulocytes or monocytes, are malignant. Usually the disease develops quickly, within a few days or weeks.
Acute myeloid leukemia - a rare disease. The risk of its development increases with age. It is the most common type of leukemia in adults. Most often it is diagnosed in older people over sixty-five years.
Causes of acute myeloid leukemia
Researchers refer to risk factors such as:
- Exposure to radiation and radon. Radiotherapy increases the risk of acute leukemia. Radon, a natural radioactive gas, a number of studies considered as one of factors.
- Smoking increases the likelihood of AML twice or three times. The presence of benzene in cigarette smoke - one of the main reasons.
- Influence of benzene during work activities - is called a risk factor.
- Some inherited diseases (Fanconi anemia, Down's syndrome) increases the risk of AML.
- Chemotherapy lymphoma or breast cancer increases the likelihood of AML, namely the use of drugs such as chlorambucil, melphalan or cyclophosphamide.
- Some diseases of the blood increase the risk of acute leukemia miloidnogo: myelodysplastic syndrome, myeloproliferative disorders.
- Autoimmune diseases - rheumatoid arthritis, autoimmune hemolytic anemia and ulcerative colitis increase the likelihood of AML eight times, compared with those people who do not have such disorders.
- Review (meta-analysis) of 21 studies showed that the consumption of alcohol during pregnancy increases the risk of AML in children.
- Several studies have outlined Overweight as risk factor when the body mass index of 30 or higher.
Symptoms of acute myeloid leukemia
Many signs of acute myeloid leukemia are vague and non-specific. A person may experience symptoms similar to the flu:
- general weakness;
- loss of body weight;
- Private infection;
- easily acquired bruises and bleeding;
- blood in the urine and stool;
- pain in the bones and joints;
- shortness of breath;
- lymph node enlargement (rarely);
- discomfort due to the swollen liver or spleen.
These symptoms are due to an excess amount of leukemic cells and a lack of healthy blood cells of all groups.
Fatigue - a consequence of the low level of red blood cells (anemia). There may also be shortness of breath.
A person can easily develop infections due to a lack of healthy white blood cells, able to fight bacteria and viruses. The disease lasts long, and difficult to get rid of it.
The lack of platelets triggers problems with blood clotting. The consequence is bleeding, bruising. In women, menstruation is very difficult to pass.
Cluster of leukemia cells in the bones, joints, lymph nodes, or due to their excessive amount causes pain and swelling.
types of AML
Acute myeloid leukemia is divided into subtypes. The doctors plan cancer treatment depending on the subtype of AML.
One of the classifications is FAB - French-American-British system. leukemia type here depends on how the leukemic cells appear under a microscope as well as by antibodies to markers of abnormal cells.
Allocate 8 types of FAB system:
M0, M1 and M2 - myelogenous leukemia, which accounts for more than half of all cases.
M3 - promyelocytic lekoz - 10% in adults, AML patients.
M4 - acute myelomonocytic leukemia - 20%.
M5 - acute monocytic leukemia - 15%.
M6- acute erythroleukemia and acute megakaryocytic leukemia - a very rare types.
WHO classification divides AML into groups depending on how the cells became abnormal:
- There are mutations in the chromosomes of the leukemic cells.
- Acute myeloid leukemia is developed on the basis of blood diseases.
- More than one type of blood cells have abnormal disturbances.
- AML occurred after treatment of oncology.
Pathologists examined leukemia cells under a microscope to determine which group of WHO or FAB belongs to the specific case of the disease. Also perform tests for specific proteins produced by abnormal cells (immunophenotyping), and mutations in the chromosomes (cytogenetic tests).
- Granulocytic sarcoma - a AML tumor cells which can be found outside of the bone marrow. They can appear in any part of the body.
- Mixed types. Some leukemias may be a mixture of AML and ALL - acute leukemia biphenotypical.
Diagnosis of acute myeloid leukemia in Assuta
With the patient runs a hematologist, an expert on the diagnosis and treatment of blood diseases. The proposed tests may include:
- Blood tests at myeloid leukemia. This is the most important study by which determine the subtype of AML FBC. Many patients with acute myeloid leukemia there is a low level of white blood cells. The high number of white blood cells may be associated with a large number of immature white blood cells, called blast cells or blasts. Also, analyzes may be performed to check the status of the kidneys and liver.
- Bone marrow examination consists of two tests - aspiration and biopsy. Aspiration involves taking the liquid using a thin needle from the hip bone, the local anesthetic is applied. When the biopsy needle used larger, the doctor removes a small amount of bone and bone marrow. Carried out simultaneously test for mutations in chromosomes (cytogenetic) and specific proteins produced by leukemic cells (immunophenotyping).
- Chest x-ray is necessary to check the overall health status.
Further diagnosis of acute myeloid leukemia in Assuta
In the course of treatment and after its completion will be blood tests needed. So, for example, in cases of suspected infection, the doctor prescribes a test to find out what types of antibiotics are needed to the patient. In addition, blood was taken to check the functioning of liver and kidney.
Bone marrow examination will be held at different times throughout the treatment and follow-up. test data can help:
- To determine the exact type of acute myeloid leukemia.
- To determine the effectiveness of cytostatic treatment.
- Checking the presence of abnormal cells after completion of therapy.
- Run the test for minimal residual disease.
HLA (tissue) typing
The test is scheduled, if the donor bone marrow transplantation is considered as a suitable embodiment. With blood tests turns tissue compatibility. Leukocytes are proteins on the surface - HLA markers. Through tissue typing doctors find out how similar tissue to reduce the likelihood of rejection.
Search abnormal cells after treatment
A small number of leukemic cells remaining after the treatment, the doctors called minimal residual disease. The blasts are not found in blood and bone marrow samples. To detect them using two tests.
PCR (polymerase chain reaction) by identifying genetic mutations finds one leukemic cell among healthy million.
Immunophenotyping detects proteins generated abnormal cells. These two tests show how well the chemotherapy worked, whether there is a recurrence of the disease.
The prognosis of acute myeloid leukemia
This provides the basic information for your reference. More accurate information based on individual factors capable of giving only doctor. Terms of the five-year and ten-year survival rates indicate the number of people participating in the study who were alive after 5 and 10 years after diagnosis and the therapy. In addition, it is the statistical data on which the treatment was carried out a few years ago. Every year the treatments are improving, so the treatment provides a better perspective now.
The prognosis of acute myeloid leukemia is influenced by such factors as:
- the body's response to chemotherapy;
- How prevalent disease at diagnosis;
- leukemia type.
The result also depends upon whether the leukemia was, which was transformed from acute chronic forms. This complicates the process of treatment.
In addition, the hard-to-leukemia therapy, which has evolved as a result of the treatment of other types of cancer. Secondary leukemia usually develops within 10 years after the first treatment of malignant disease.
Doctors even if they can not cure the disease, are able to retain leukemia in remission for several years. At relapse of AML in some cases it is possible to achieve a second remission by chemotherapy.
prospects for AML
Age - one of the most important prognostic factors. The young body is much better at a very intense therapy.
In general, 20% of AML patients say 5-year survival rate for all ages. For more information on the 5-year survival rates, taking into account the age factor:
- 14 years and younger - to 66%.
- 15-24 years - 60%
- 25-64 - for 40%.
- 65 years and older - to 5%.