Leukemia is a type
of blood cancer that affects the body's white blood cells (WBCs).
Normally, WBCs help fight infection and protect the body against disease. But in
leukemia, white blood cells turn cancerous and don't work as they should. As more
cancerous cells form in the blood and bone marrow (spongy tissue inside the bones),
there's less room for healthy cells.
What Is Acute Myeloid Leukemia?
Acute myeloid leukemia (AML) happens when the body makes too many immature white
blood cells. These cells, called myeloid blasts, can't mature into normal white blood
Because AML develops and gets worse quickly, prompt treatment is very important.
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.
What Causes Acute Myeloid Leukemia?
The cause of acute myeloid leukemia is unknown. Some medical conditions can increase
a child's risk of getting it. But just having a risk factor doesn't mean that a child
will get AML.
Who Gets Acute Myeloid Leukemia?
Risks factors for kids include:
having an identical twin who had leukemia before age 6
being a fraternal twin or other sibling of a child with leukemia
having an inherited genetic problems such as Li Fraumeni syndrome, Down
syndrome, or Fanconi anemia
having a non-inherited conditions such as myelodysplasia syndrome (a kind of pre-leukemia
that stops blood cells from growing normally)
having a condition called aplastic anemia (when the bone marrow doesn't make enough
easy bruising or petechiae (tiny red spots on the skin caused by easy bleeding)
bone and joint pain
belly pain (caused by the build-up of cells in organs like the kidneys, liver,
How Is Acute Myeloid Leukemia Diagnosed?
If a doctor suspects leukemia, a child may have these tests:
Blood tests. Tests such as a complete
blood count, liver function
and kidney function panels, and blood chemistries can give important information about
the number of normal blood cells in the body and how well the organs are working.
The shapes and sizes of the blood cells are checked with a microscope.
Imaging studies. These may include an X-ray, CT scan, MRI,
or ultrasound. These studies can see whether there's a mass of leukemia cells in the
chest that could affect breathing or blood circulation. They also can help doctors
rule out other possible causes of a child's symptoms.
Bone marrow aspiration
and biopsy. In this procedure, the doctor inserts a needle into a large
bone, usually the hip, and removes a small amount of bone marrow. The lab does these
tests on the bone marrow sample:
Flow cytometry tests. Doctors carefully look at the cancer cells
and figure out the type and subtype of the leukemia. This is important because treatment
varies among different types of leukemia.
By looking carefully at the blood or bone marrow, doctors check for changes in the
genes. This can help doctors figure out the best treatment.
Lumbar puncture (spinal (tap). Doctors
use a hollow needle to remove a sample of cerebrospinal fluid (the fluid surrounding
the brain and spinal cord) for exam in a lab.
How Is Acute Myeloid Leukemia Treated?
Doctors usually treat children who have acute myeloid leukemia with chemotherapy.
These special drugs kill cancer cells. Which drugs a child gets and in what combination
depends on the subtype of AML and and whether the cancer cells have mutations (genetic
changes). How the cancer responds to the initial treatment is also important in choosing
the type of chemo.
Doctors can give chemo:
through a vein
as an injection into a muscle
by mouth in pill form
with a spinal tap right into the cerebrospinal fluid, where cancerous WBCs can
The treatment goal is remission,
which is when tests don't find any cancer cells in the body. Then, maintenance
chemotherapy is used to keep the child in remission and prevent the cancer
from coming back. The child will get maintenance chemo for 2 to 3 years.
Stem Cell Transplants
Kids who have an aggressive type of AML might need a stem
cell transplant. Also called a bone marrow transplant, this involves:
destroying cancer cells, normal bone marrow, and immune system cells with high-dose
chemotherapy and/or radiation
putting healthy donor stem cells back into the body
rebuilding a healthy blood supply and immune system with the new stem cells
Clinical trials are research studies that offer promising new treatments not yet
available to the public. Doctors will decide if a child is a good candidate for a
Learning that a child has cancer is upsetting, and cancer treatment can be stressful
for any family.
But remember, you're not alone. To find support,
talk to your doctor or a hospital social worker. Many resources are available to help
you get through this difficult time.