Acute Myelogenous Leukemia (AML) is one type of blood cancer and bone marrow. Bone marrow is the spongy tissue in the bones where blood cells are made. The disease is also known as acute myeloblastic leukemia, acute nonlymphocytic leukemia, acute myeloblastic leukemia and acute myeloid leukemia. In AML, the word “acute” refers to the fact that this disease affects the blood cells are immature and evolving rapidly. “Myelogenous” refers to white blood cells, called myeloid cells that affect AML cells. Myeloid cells develop into different types of mature blood cells, such as white blood cells, red blood cells, and platelets.
Cause
AML occurs when the DNA of cells growing in bone marrow are damaged, causing the production of blood cells becomes uneven. Immature cells seem to be produced by the bone marrow, which develop into myeloblasts, white blood cells of leukemia. Abnormal cells can not function properly, so that the abnormal cells develop in healthy cells. Although the cause DNA mutations that cause leukemia are not clear, but the radiation, exposure to certain chemicals and some chemotherapy drugs are thought to be the cause. This is reinforced by data that, in most cases of AML is not inherited.
Symptom
Many of the signs and symptoms of early stages of AML, which can resemble those of flu or other common illnesses. These signs can also vary according to the type of blood cell affected. Signs and symptoms of AML include:
- Bone pain
- Pale skin
- Easy bruising
- Shortness of breath
- Fever
- Lethargy and fatigue
- Frequent infections
- Weight loss
- Bleeding from the gums, frequent nosebleeds, and other unusual bleeding.
AML deteriorate rapidly if not treated, so that proper diagnosis is very helpful. In the case of exceptional or alarming signs and symptoms should immediately consult a physician.
Treatment
Treatment of AML depends on several factors, such as patient’s age, overall health, preferences, and disease subtype. Treatment of this disease has two phases, namely:
1. Phase 1: Induction Therapy
In this phase of leukemia cells in the blood and bone marrow were killed, but for the purpose of preventing disease recur, further treatment is needed for induction of remission is usually not relieve all leukemia cells.
2. Phase 2: Consolidation Therapy
In this phase of the leukemia cells remaining were destroyed. Also called post-remission, maintenance therapy or intensification. Consolidation therapy is considered essential to reduce the risk of relapse. Several methods of therapy used in this phase include:
a. Biological Therapy
This method, also known as immunotherapy, uses a substance that strengthens the immune system response against cancer. One form of biological therapy known as monoclonal antibodies. Although these antibodies are produced in the laboratory, but can mimic the protein in the immune system (antibodies) that attack foreign substances on leukemia cells. Gemtuzumab ozogamicin is a monoclonal antibody used as a biological therapy in AML. When these drugs attach to cells of AML, it releases toxic chemicals carried.
b. Chemotherapy
Although it can also be used as consolidation therapy, this method is the major form of remission induction therapy, which uses chemicals to kill cancer cells in the body. Because many chemotherapy drugs destroy normal blood cells in the process of killing leukemia cells, so patients must stay in the hospital for this therapy. This treatment may need to be repeated one or more than twice in the case of the first cycle of chemotherapy which did not lead to remission.
c. Bone marrow stem cell transplantation
This method can help in rebuilding the stem cells healthy by replacing unhealthy bone marrow with cells that are free of leukemia stem cells that will regenerate healthy bone marrow. This method can be used for consolidation therapy. To destroy the bone marrow and produce benefits in patients with leukemia, it will be given very high doses of chemotherapy or radiation therapy prior to stem cell transplantation. After that, it will be given infusions of stem cells from a compatible donor (allogeneic transplant). Person’s own stem cells can also be used (autologous transplantation), namely by taking and storing stem cells healthy for transplant them in the future.
d. Other drug therapy
There are anti-cancer drug that can be used alone or in combination with chemotherapy for remission induction of a specific subtype of AML called promyelocytic leukemia, such as arsenic trioxide and all trans retinoic acid
