About acute myeloid leukemia

Acute myeloid leukemia (AML) is a type of cancer that affects the bone marrow and blood. It is characterized by the rapid proliferation of abnormal myeloid precursor cells, leading to the suppression of normal blood cell production. AML is a heterogeneous disease with various subtypes, each with distinct clinical, genetic, and prognostic features.

Here are some key points about acute myeloid leukemia:

  1. Epidemiology: AML is the most common type of acute leukemia in adults, with the highest incidence among individuals aged 65 and older. It can also occur in children and younger adults, but it is less common in these age groups.
  2. Pathogenesis: The development of AML is typically preceded by genetic mutations or chromosomal abnormalities in hematopoietic stem cells or myeloid progenitor cells. These mutations disrupt normal hematopoiesis and lead to the uncontrolled proliferation of immature myeloid cells. Common genetic abnormalities in AML include mutations in genes such as FLT3, NPM1, and CEBPA, as well as chromosomal rearrangements involving genes like RUNX1, MLL, and PML-RARA.
  3. Clinical Presentation: The clinical presentation of AML can vary depending on factors such as the patient’s age, overall health, and subtype of AML. Common symptoms may include:
  • Fatigue and weakness
  • Shortness of breath
  • Easy bruising or bleeding
  • Fever and frequent infections
  • Bone pain or joint pain
  • Enlarged lymph nodes, liver, or spleen
  1. Diagnosis: Diagnosis of AML involves a combination of clinical evaluation, blood tests, bone marrow aspiration and biopsy, and genetic testing. Key diagnostic tests include:
  • Complete blood count (CBC) and peripheral blood smear
  • Bone marrow aspiration and biopsy to examine the morphology and genetic characteristics of leukemia cells
  • Flow cytometry and immunophenotyping to identify specific cell surface markers expressed by the leukemia cells
  • Cytogenetic analysis and molecular testing to detect chromosomal abnormalities and genetic mutations associated with AML
  1. Treatment: Treatment of AML typically involves induction chemotherapy to achieve remission, followed by consolidation therapy to prevent relapse and maintenance therapy for eligible patients. Chemotherapy regimens may include combinations of cytarabine and anthracycline drugs. Allogeneic stem cell transplantation may be considered for eligible patients, particularly those with high-risk disease or who have relapsed after initial therapy. Targeted therapies, such as FLT3 inhibitors or IDH inhibitors, may be used in combination with chemotherapy for patients with specific genetic mutations.
  2. Prognosis: The prognosis for AML varies depending on factors such as the patient’s age, cytogenetic and molecular characteristics of the leukemia cells, and response to treatment. Overall, AML is associated with a poor prognosis, particularly in older adults and patients with high-risk disease features. However, recent advances in treatment, including targeted therapies and stem cell transplantation, have improved outcomes for some patients with AML.

In summary, acute myeloid leukemia is a complex and aggressive hematologic malignancy that requires a multidisciplinary approach to diagnosis and treatment. Close collaboration among hematologists, oncologists, pathologists, and other healthcare professionals is essential to optimize patient care and improve outcomes for individuals affected by this disease.