Acute Myelogenous Leukemia – Diagnosis and Treatment
Diagnosis
Checking the Blood for Changes
Doctors usually begin diagnosis by looking at a person’s blood. A test called a complete blood count checks the number of red blood cells, white blood cells, and platelets in a sample.
In acute myeloid leukemia, these numbers are often abnormal. There are usually not enough red blood cells (which can cause anemia), and platelet counts may be lower than usual.
Sometimes, the test finds very immature white blood cells called myeloblasts in the blood. Unlike mature neutrophils or monocytes, myeloblasts are not normally present in healthy people’s blood. Their presence signals AML.
Below is a simple table showing what can be found in AMC blood tests:
| Blood Component | Possible Change in AML |
|---|---|
| Red Blood Cells | Decreased (anemia) |
| White Blood Cells | Increased or decreased |
| Platelets | Decreased |
| Myeloblasts | Present (abnormal finding) |
Examining Bone Marrow Cells
To confirm AML, doctors collect bone marrow samples. They do this with a needle inserted into a large bone, often the hip.
There are two parts to this process: aspiration (drawing out the liquid part of the bone marrow) and biopsy (removing a small amount of bone and marrow tissue).
Pathologists in the lab examine these samples under a microscope. They look for abnormal cells, such as myeloblasts, and test for DNA or chromosome changes.
Identifying certain genetic changes in the bone marrow cells helps classify the specific type of AML.
Spinal Fluid Collection
In some cases, doctors need to know if leukemia has moved into the central nervous system.
When this is a concern, a doctor performs a lumbar puncture, or spinal tap, using a thin needle to remove a small amount of fluid from the lower back.
Lab staff then check the fluid, which surrounds the brain and spinal cord, for leukemia cells.
Using Body Scans
Doctors sometimes order scans to see if AML has spread to areas such as the brain or other organs. They may use CT (computed tomography) or MRI (magnetic resonance imaging) scans.
A PET (positron emission tomography) scan can also provide a more complete picture, especially when spread to other parts of the body is suspected.
Deciding the AML Type
Not all cases of acute myeloid leukemia are the same. After initial testing, further lab studies help determine which subtype of AML a person has.
This usually involves looking at the blood and bone marrow cells in more detail, including studying the DNA or chromosomes. There are about 15 different AML subtypes.
Knowing the specific kind of AML helps doctors select the right treatment and provides more information about what to expect from therapy. Each subtype may react differently to treatments and can have different outcomes and risk factors.
Genetic testing can also help spot specific mutations, such as those seen in acute promyelocytic leukemia or AML that began from myelodysplastic syndrome or from exposure to chemicals like benzene or a history of smoking.
Treatment
Treating acute myelogenous leukemia (AML) involves several different approaches, depending on the specific characteristics of the disease and the patient’s needs.
Most treatment plans for AML have two main phases: the first aims to remove as many leukemia cells as possible, and the second seeks to reduce the chance of the disease returning.
Key Treatment Phases
| Phase Name | Main Goal |
|---|---|
| Induction Chemotherapy | Destroy active leukemia cells. |
| Post-Remission Therapy | Eliminate any leftover cancer cells. |
| Maintenance Therapy | Help prevent leukemia from coming back. |
Main Treatment Options
Chemotherapy: Doctors use powerful medicines, often given directly into a vein, to target and kill leukemia cells throughout the body. If remission is not reached after the first cycle, doctors may repeat treatment. Chemotherapy often requires a hospital stay because it lowers the body’s blood cell counts, increasing the risk of infection and other complications. Side effects can include nausea, hair loss, tiredness, and increased vulnerability to other illnesses.
Targeted Therapy: Doctors prescribe targeted medicines to block certain substances found only in cancer cells, causing these cells to die while sparing more healthy cells. For some forms of AML, medication such as gemtuzumab ozogamicin can be used, alone or combined with chemotherapy. Whether targeted therapy is suitable depends on the patient’s specific leukemia type.
Stem Cell Transplant: Doctors may recommend a bone marrow transplant to replace damaged bone marrow with healthy stem cells. Before the transplant, patients receive high doses of chemotherapy and sometimes radiation therapy to remove the diseased cells. Medical staff then give stem cells from a matched donor through a drip to help rebuild healthy blood cells. There is a higher risk of infection following the procedure, so patients may need to stay in the hospital for a longer time.
Radiation Therapy: Doctors occasionally use strong X-rays or other forms of energy to destroy remaining leukemia cells, especially if cancer has spread beyond the bone marrow.
Each patient’s treatment plan depends on the type of AML, age, general health, and personal preferences. Doctors work with individuals to decide on the most suitable approach, often combining two or more of the above methods.
Complementary Approaches
Practices such as acupuncture, massage, meditation, and yoga can support standard medical care to help manage stress and side effects related to acute myelogenous leukemia.
Simple activities like light exercise and creative therapies, including art and music, may help support well-being. Good nutrition can also play a role in helping patients feel stronger.
Ways to Manage and Find Help
People facing acute myelogenous leukemia often benefit from clear information and a strong support network. Keeping a list of specific facts given by a doctor can help patients avoid wasting time on unrelated research.
Support from families, friends, and groups can make a major difference. Some find comfort in talking with others going through similar situations, either in-person or online. Having someone to listen or help with daily tasks can ease stress and worry.
Practicing self-care is also important. Making time for relaxing or enjoyable activities can help balance the demands of treatment. Simple activities, such as cooking, reading, or enjoying sports, may bring comfort.
Keeping a routine, getting enough sleep, and spending time outdoors can help improve mood and energy. Handling infections is a key part of living with acute myelogenous leukemia.
Because the immune system is weaker, patients need to be careful about hygiene and avoid people who are sick. Using a table like the one below can help track steps to reduce infection risk:
| Step | Example |
|---|---|
| Wash hands often | After using the bathroom |
| Avoid crowded places | During flu season |
| Clean surfaces | Wipe down kitchen counters |
| Check for fever daily | Use a thermometer at home |
If approved by a healthcare professional, light exercise can keep the body strong and help lift mood. Even gentle walks or stretching can be valuable if done regularly.
Getting Ready for Your Visit
Steps to Take Before Your Visit
Patients should check if there are any special instructions before their appointment, such as avoiding certain foods or drinks. These details can be important, especially before blood tests.
It helps to keep a detailed list of symptoms, even if some do not seem related to their main concern. Writing them down makes it easier to remember everything when speaking with the doctor.
Important personal events or recent changes, such as stress or major life events, should also be listed. These can affect health and may help the doctor understand a patient’s situation better.
All medications, vitamins, and supplements currently being taken should be noted, including doses. This helps prevent possible drug interactions and gives a full picture of the medical history.
Taking a family member or close friend is a good idea. Extra support can help with remembering information and asking questions that might be missed.
Preparing questions ahead of time is useful because appointments are often short. Patients might want to know about possible causes of their symptoms, what tests are needed, and what treatments might be offered.
Other useful questions could include:
| Topic | Example Questions |
|---|---|
| Symptoms | What is likely causing my symptoms? Are there other possible causes? |
| Testing | Will more tests be needed? Which ones? |
| Treatment | What options are available? What are the side effects? |
| Life Impact | How will treatment affect my daily life? Will I need to make changes? |
| Medication | Are there generic options? |
It is okay to ask other questions as they come up during the appointment.
Questions Patients Might Hear From Their Doctor
Doctors will often have questions to help guide their care. These may include:
- When did the symptoms first appear?
- Are the symptoms constant or do they come and go?
- How severe are the symptoms?
- Does anything make the symptoms better or worse?
Having this information ready helps the doctor understand the case and allows more time for other questions.
What to Do While Waiting for Your Appointment
If certain activities make symptoms worse, avoid them. For example, get plenty of rest if tiredness is a problem.
Try not to worry, but focus on simple steps to stay comfortable until the visit. Keep notes each day about symptoms or anything that has changed to share with the doctor.
