|SSM Cardinal Glennon Children's Medical Center|
Acute Myeloid Leukemia (AML)
Leukemia is a type of cancer that affects the body's white blood cells (WBCs).
Normally, WBCs help fight infection and protect the body against disease. But in leukemia, WBCs turn cancerous and multiply when they shouldn't, resulting in too many abnormal WBCs, which then interfere with the body's ability to work as it should.
In acute myeloid leukemia (AML), too many immature white blood cells (called myeloid blasts) are made. These leukemia cells are abnormal and cannot mature into normal white blood cells. Of kids who have leukemia, 20% have AML.
Thanks to advances in therapy and clinical trials, the outlook for kids with AML has improved. With treatment, most are cured.
The cause of AML is unknown, though doctors know that certain medical conditions can increase a child's risk of getting it. However, just because a child has a risk factor does not mean that he or she will get AML.
Risks include inherited genetic problems such as Down syndrome, neurofibromatosis type 1, Fanconi anemia, Noonan syndrome, and other inherited bone marrow failure syndromes (IBMFS). Also, non-inherited conditions such as preleukemia (also called myelodysplastic syndrome, or MDS) and aplastic anemia can increase the risk of AML.
A child with an identical twin who was diagnosed with leukemia before age 6 has a 20% to 25% chance of developing AML. Fraternal twins and other siblings of kids with leukemia have two to four times the average risk of developing it, too.
Certain environmental factors can predispose a child to leukemia. For example, exposure to radiation (such as X-rays) before birth may trigger the disease in a developing fetus.
Signs and Symptoms
AML is called "acute" because it tends to worsen quickly if it's not treated. Chronic blood cancers, like chronic myelogenous leukemia (CML), tend to progress more slowly. However, the symptoms of all types of leukemia are generally the same and include:
Sometimes a child might have painless lumps that can be felt in the lymph nodes of the neck, underarm, or groin area. These lumps of leukemia cells (called chloromas) can develop anywhere in the body.
If a doctor suspects leukemia, a child may undergo tests that include:
Because it can progress so quickly, there is no staging system for AML. Doctors generally characterize the disease as newly diagnosed or in remission.
Treatment is divided into two phases. The goal of the first phase, called induction, is to kill as many cancer cells as possible and achieve remission (a state where there is no evidence of disease in the body). The second phase — called post-remission, consolidation, or continuation therapy — is designed to eliminate any undetectable leukemia cells to prevent the leukemia from coming back.
Phases I and II of treatment may include the following therapies alone or in combination:
Being told that a child has cancer can be terrifying, and the stress of cancer treatment can feel overwhelming for any family.
Although you might feel like it at times, you're not alone. To find support that might help you or your child, talk to your doctor or a hospital social worker. Many resources are available to help you get through this difficult time.
Reviewed by: Emi H. Caywood, MD