What is acute myeloid leukemia (AML)?
Acute myeloid leukemia, or AML, is a type of cancer that affects the bone marrow and blood. It’s known by a variety of names, including acute myelogenous leukemia and acute non-lymphocytic leukemia. AML is the second most common leukemia type in adults.
Doctors call AML “acute” because the condition can progress rapidly. The term “leukemia” refers to cancers of the bone marrow and blood cells. The word myeloid, or myelogenous, refers to the cell type it affects.
Myeloid cells are precursors to other blood cells. Usually these cells go on to develop into red blood cells (RBCs), platelets, and special types of white blood cells (WBCs). But in AML, they aren’t able to develop normally.
When a person has AML, their myeloid cells mutate and form leukemic blasts. These cells don’t function as normal cells do. They can keep the body from making normal, healthy cells.
Eventually, a person will start to lack RBCs that carry oxygen, platelets that prevent easy bleeding, and WBCs that protect the body from diseases. That’s because their body is too busy making the leukemic blast cells.
The result can be deadly. However, for many people, AML is a treatable disease.
Advancements in cancer treatments and doctors’ understanding of the disease mean that more and more people survive the condition each year.
Every year doctors diagnose an estimated 19,520 people in the United States with AML. An estimated 10,670 deaths occur on a yearly basis because of the disease.
Most people with AML receive chemotherapy treatments. These medications rapidly kill dividing cells, such as cancer cells. Chemotherapy can lead to remission, which means a person doesn’t have symptoms of the disease and their blood cell counts are in a normal range.
Around 90 percent of people with an AML type known as acute promyelocytic leukemia (APL) will go into remission after “induction” (first round) of chemo. This is according to the American Cancer Society (ACS). For most other types of AML, the remission rate is around 67 percent.
Those older than age 60 don’t typically respond to treatment as well, with about half of them going into remission after induction.
Some people who go into remission stay in remission. Still, for many, AML can return over time.
The five-year overall survival rate for AML is 27.4 percent, according to the National Cancer Institute (NCI). This means that of the tens of thousands of Americans living with AML, an estimated 27.4 percent are still living five years after their diagnosis.
Children with AML
In general, children with AML are seen as lower risk than adults. Around 85 to 90 percent of children with AML will go into remission after induction, according to the American Cancer Society. AML will return in some cases.
The five-year-survival-rate for children with AML is 60 to 70 percent.
The outlook and prognosis for AML varies widely. Doctors consider many factors when giving someone a prognosis, such as the person’s age or type of AML.
Some people with a poor prognosis live many more years than a doctor predicts while others may not live as long.
The median age of a person diagnosed with AML is 68 years old.
Age can be a major factor in determining AML treatment response. Doctors know that survival rates for those diagnosed with AML are more promising for people who are under the age of 60.
This could be for a number of reasons. Some people older than the age of 60 may have chronic conditions or may not be in good health. This can make it difficult for their bodies to handle the strong chemotherapy medications and other cancer treatments associated with AML.
Moreover, many older adults with AML don’t receive treatment for the condition.
A 2015 study found that only 40 percent of people 66 and up received chemotherapy within three months of diagnosis. Despite the differences in treatment response among different age groups (or cohorts), overall survival rates for people between 65 and 74 years old have improved over the past three decades, according to a 2011 study.
Doctors often classify the different types of AML by their cell mutations. Some cell mutation types are known to be more responsive to treatments. Examples include mutated CEBPA and inv(16) CBFB-MYH11 cells.
Some cell mutations can be very treatment-resistant. Examples include del(5q) and inv(3) RPN1-EVI1. Your oncologist will tell you what type or types of cell mutation you may have.
Some people respond better to treatment than others. If a person receives chemotherapy treatments and their cancer doesn’t come back within five years, they’re usually considered cured.
If a person’s cancer comes back or doesn’t respond to treatments at all, their treatment outcome isn’t as favorable.
Regardless of prognosis, an AML diagnosis can create emotions of fear, anxiety, and uncertainty. You may be unsure where to turn or seek support.
A cancer diagnosis presents the opportunity for you to grow nearer to those closest to you and evaluate how you can live a life you enjoy.
Here are a few tips to help you navigate this diagnosis and treatment.
It’s important that you understand your condition. If there’s something you’re uncertain of regarding your diagnosis, treatment, or prognosis, ask your doctor.
Examples of questions to ask could include “What are my treatment options?” and “What can I do to prevent AML from coming back?”
Find organizations that provide support
Organizations such as the American Cancer Society (ACS) offer a number of supportive services.
These include arranging rides to treatment and helping you find assistive personnel, such as dietitians or social workers.
Join a support group
Support groups are an excellent way to meet individuals who are going through similar emotions as you. Seeing the successes and mindsets of others can help you know you aren’t alone.
In addition to resources such as the ACS and LLS, your oncologist or local hospital may offer support groups.
Reach out to friends and family
Many friends and family members will want to help. Let them deliver meals through a service such as Meal Train or simply listen to your concerns. Opening up to others can help you maintain a positive frame of mind.
Find enjoyable ways to relieve stress
Finding an outlet that you especially enjoy can do wonders for your mind and spirit.