Acute myeloid leukaemia (AML) is a cancer found in the blood and bone marrow. It is the most common acute leukaemia found in adults and unfortunately can get worse quickly if left untreated. Thanks to you, researchers are helping to find new cures, so here we answer your questions about AML and share how this research is bringing hope to those affected.
Is acute myeloid leukaemia curable?
Acute myeloid leukaemia can be treated and some patients can go into remission, meaning the cancer is reduced or completely gone. There are a few factors that can affect AML prognosis, mainly age. Around 40% of patients under the age of 40 will survive for more than 5 years after their AML diagnosis. Sadly, this statistic drops to less than 10% for patients aged 60 and over.
A patients overall health and the subtype of AML they have can also affect how successful treatment is. Current treatment options are sadly still very aggressive, and how well a patient can tolerate and recover from these difficult treatments can also play a critical role in determining treatment outcomes.
AML has a few different subtypes which can all respond to treatment differently. While these different variables can affect treatment success, individual experiences can vary widely and it is always best to work with your medical care team to work out the best plan for you.
What is the difference between AML and other blood cancers?
Data from 2022 shows that AML is quite a rare cancer, accounting for 1% of all new cancer cases in the UK. it is sometimes also referred to as acute myelogenous leukaemia or acute nonlymphocytic leukaemia.
Myelodysplastic syndromes (MDS) and myeloproliferative neoplasms (MPN) are types of blood cancers linked to AML. In MDS and MPN the bone marrow produces abnormal or too many stem cells respectively. Sometimes blood cancers can share characteristics of both these groups, this is called MDS/MPN overlap syndrome. Around 4 in 10 patients with this syndrome will go on to develop AML.
Chronic myeloid leukaemia (CML) is another blood cancer AML is often linked to. AML and CML are two different types of leukaemia that affect the same type of cells in the bone marrow with the main difference being how fast they develop. AML progresses rapidly with under developed cells, while CML progresses slowly with mature but abnormal cells.
What causes acute myeloid leukaemia?
Scientists still do not know what exactly causes AML. They do know that changes (mutations) in our genes can cause blood cells to grow abnormally and this kickstarts AML development. Mutations in our genes can sometimes just randomly occur throughout our lives, but there are some factors that increase the risk of AML development:
Some rare, inherited conditions such as bloom syndrome, Fanconi anaemia and Li Fraumeni syndrome.
Long term exposure to a chemical compound called benzene, usually through working in industries such as oil refineries, pharmaceuticals and printing.
Exposure to ionising radiation.
Long term exposure to petrol fumes, usually through working closely with it, for example as a mechanic.
Autoimmune conditions such as rheumatoid arthritis, autoimmune haemolytic anaemia and ulcerative colitis. Scientists are still not sure if this increased risk is from the conditions themselves or the drugs used to treat them.
What are the symptoms of acute myeloid leukaemia?
Symptoms of AML can be quite sudden and often develop up to 6 weeks before diagnosis. The earliest symptoms feel similar to a cold or flu with fatigue, fever and infection being key signs. As the disease progresses symptoms can start to become more distinct or noticeable:
Bruising or bleeding easier than usual e.g., frequent nosebleeds
Dizziness
Night sweats
Loss of appetite and/or unexplained weight loss
Pain in the bones back and abdomen
Shortness of breath (dyspnea)
Tiny red spots on the skin (petechiae)
Infections and wounds that won’t go away
Swollen lymph nodes
How is acute myeloid leukaemia diagnosed?
To diagnose AML, a specialist will perform a series of tests including physical examinations, blood tests and genetic tests which may include:
Complete blood count (CBC): a blood test that measures the size and count of your red blood cells, haemoglobin, white blood cells and platelets.
Peripheral blood smear: a test used to examine what red and white blood cells and platelets look like under a microscope.
Bone marrow biopsy: a small amount of soft tissue is taken from your bone marrow to see what is happening to the cells and tissue.
Spinal tap: a doctor removes cerebrospinal fluid from your spine under anaesthetic.
Doctors may also perform different genetic tests to identify which subtype of AML is present because knowing this helps the clinical team figure out what the best treatment options may be.
How is acute myeloid leukaemia treated?
Patients with AML will often work with their medical team to create a personalised treatment plan, choosing therapies that will work best for them and their cancer. This may include:
Chemotherapy
Chemotherapy uses a mixture of cytotoxic drugs that kill cancer cells. The exact mixture and administration method will depend on the subtype and stage of AML.
Radiotherapy
Radiotherapy involves high energy radiation beams zapping cancer cells to damage them and stop them from growing.
Stem cell transplant
After high doses of chemotherapy or radiotherapy, patients can be donated healthy stem cells (immature blood cells), to help their body recover and restore healthy cells.
Targeted treatments
Targeted treatments are drugs that have been developed to target specific parts of AML cells, these include midostaurin, gemtuzumab, venetoclax, gilteritinib and ivosidenib.
Why does research into acute myeloid leukaemia matter?
AML remains an aggressive and difficult to treat blood cancer. Where it can be treated successfully, options are intensive and can be brutal for patients, especially older ones. There is a serious need for more effective and kinder treatment options for patients.
There is important international cancer research ongoing trying to understand AML better. The main gaps in research scientists want to explore are why certain subtypes do not respond as well to treatment and how we can stop patients from relapsing.
How can we make a difference to people with AML?
Worldwide Cancer Research supports researchers that seek to answer the difficult questions in cancer biology. We know that clinical breakthroughs that impact patients only happen if we fund discovery research that takes that first leap into the unknown. Our focus on discovery research and helping scientists to explore brand new concepts and approaches, sets in motion the journey towards clinical trials, and ultimately, new tests and treatments that impact the lives of people with cancer.
We have funded over £16million into blood cancer research since we were founded in 1979, but we know more work still needs to be done.
We are currently funding Professor Brian Huntly and his team in Cambridge to explore one of the cancer causing mutations found in AML. They hope by better understanding how the leukaemia starts they can find clues towards a vital new cure.
There are still blood cancers that we find very hard to treat, and these include AML…we are aiming to identify targets for drugs that will not only treat but may prevent or delay the onset of cancer. This ability would signal a step-change in cancer care, moving from treating established cancers to delaying or even preventing cancer development.
Your acute myeloid leukaemia FAQs:
How common is AML in the UK?
AML is quite rare in the UK. Over 2,900 people in the UK are diagnosed with AML every year, accounting for around 1% of all new cancer cases in the UK yearly.
Can AML be inherited?
There are some inherited syndromes we know can increase your risk of AML developing such as bloom syndrome, Fanconi anaemia and Li Fraumeni syndrome. AML itself though cannot be inherited and in most cases we do not fully understand what causes it.
What is the survival rate for AML?
In the UK, around 40% of patients under the age of 40 will survive for more than 5 years after their AML diagnosis. Sadly, this statistic drops to less than 10% for patients aged 60 and over. If you or a loved one have received a diagnoses of AML please speak to your oncology team since individual prognosis depends on a number of factors.
Can AML come back after treatment?
Yes AML can come back aftertreatment, this is called relapse. If some leukaemia cells survive treatment and are small enough they go undetected, they can become resistant and start multiplying again. Sadly, relapsed AML is harder to treat but recovery is still possible for some patients.
What is the difference between AML and ALL?
Acute Myeloid Leukaemia (AML) and Acute Lymphoblastic Leukaemia (ALL) are both fast-growing (acute) blood cancers, however they both affect different cells. AML forms from myeloid cells, which form red and some white blood cells. ALL develops from immune cells called B or T lymphocytes.
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