by The Welthi Bureau | 23 FEB 2018
Acute Myeloid Leukaemia (AML) is an aggressive cancer of the blood and bone marrow cells and a difficult disease to cure. AML is the most common acute leukaemia affecting adults. Older people are more likely to develop AML than younger adults or children. Till about a few decades ago there was no cure for AML in adults. In today’s time, however, there have been major advances in AML treatment which have resulted in improved remission and cure rates. AML affects a group of white blood cells called myeloid cells which are formed in the bone marrow. In this condition, myeloid blasts are produced in an enormous and uncontrolled manner, requiring immediate treatment. The overgrowth of blast cells leads to an inadequate number of normal, healthy blood cells, including white blood cells, red blood cells, and platelets.
This can result in:
Neutropenia (low numbers of neutrophils) – Neutrophils are a type of white blood cell that helps to fight infection. People with neutropenia are more likely to get infections.
Anemia (low numbers of red blood cells) – Red blood cells circulate in the blood vessels and carry oxygen to our tissues. People without enough red cells may be pale and are often tired and short of breath.
Thrombocytopenia (low numbers of platelets) – Platelets are small cells in the blood that help to prevent and stop bleeding. People with low platelets have bleeding and spontaneous bruising.
Causes and Risk Factors of AML:
Some types of chemotherapy
Radiation used to treat cancer
Repeated contact with the chemical benzene
Signs and Symptoms: A person with signs and symptoms that suggest the possibility of leukaemia is usually referred to a specialist either a haematologist or an oncologist. Patient can also have loss of appetite and weight loss, discomfort in bones or joints, enlarged liver and spleen.
Two important causes of AML mortality include
Bleeding: A low platelet count predisposes patients to bleeding. Bleeding in the brain or lung is serious and can be fatal. However, such bleeding is usually preceded by minor bleeding, such as nose bleeds, blood in the urine or bruises.
Infection: Severe infection can occur at the time of diagnosis but becomes more common and often more serious during treatment, when the bone marrow is completely suppressed. If the neutrophil count becomes or remains low because of AML or its treatment, serious infection almost invariably occurs and is a leading cause of death from AML.
AML is diagnosed with blood and bone marrow tests. Most children who are diagnosed with leukemia have acute lymphoblastic (lymphocytic) leukemia. Acute myeloid leukemia accounts for about 15 to 20 percent of cases of acute childhood leukemia.
Children who have AML are treated with an induction therapy similar to that for adults with cytarabine and drugs such as doxorubicin or daunomycin, or a third drug, such as mitoxantrone.
This treatment is followed by a complex multidrug program that results in about an 80 percent remission rate and a nearly 50 percent 5-year, relapse-free remission rate. Slightly more than half of the children in relapse-free remission are considered cured. Infants are usually treated with the same therapy.
Allogeneic stem cell transplantation may be used to treat children who have:
Worse risk, based on cytogenetic and molecular test results
Primary induction failure
Relapse after intensive multidrug therapy.
Treatment Outcomes: As infections are the leading cause of morbidity and mortality for patients with AML because of disease or treatment complications. Infections also lead to increased financial burden. With the concept of decreasing infections, management of Bhagwan Mahaveer Cancer Hospital has taken a unique initiative of starting AML ward - first of its type in the state of Rajasthan. In AML ward we treat exclusively AML patients with three- tier barrier facility to prevent infections. Our vision is that one day most people who have been diagnosed with acute myeloid leukemia (AML) will be cured or will be able to manage their disease and lead a good quality life.
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