Acute myelomonocytic leukemia (AMML) is a rare type of acute myeloid leukemia (AML), which is a cancer that affects blood cells in the bone marrow — a spongy substance found in the center of bones.
Your body contains many types of white blood cells. With AMML, there’s an increased production of specialized white blood cells known as blast cells. These cells multiply uncontrollably and fail to mature properly. When the blast cells take up space in the bone marrow, healthy cells can’t be made.
The two types of AMML are based on how many eosinophils someone has in their blood. Eosinophils are white blood cells that normally protect against allergens and parasites.
One type of AMML is characterized by an increased eosinophil count, while the other is not.
The exact cause of AMML isn’t fully understood, but researchers do know that certain gene changes can lead to cancer.
One of the most common genetic mutations seen in people with AMML happens when part of chromosome 16 becomes flipped around. This is known as inversion 16.
Another chromosome difference linked with AMML is 11q23/KMT2A.
AMML tends to affect slightly more men than women. The median age for people with the disease is 50 years old.
Some early symptoms of AMML are:
Other symptoms may include:
Typically, doctors diagnose AMML by performing one or more of the following:
- Bone marrow biopsy. This test involves collecting a sample of bone marrow from the hip bone. The blood and bone marrow are examined under a microscope, so experts can analyze the cells.
- A full blood count. A blood test can reveal a breakdown of the different white cell counts, so your doctor can see which are involved.
- Immunophenotyping and chromosome analysis. Sometimes, doctors perform these specialized tests to help identify the type of leukemia, provide more information about the cancer, or determine appropriate treatment options.
The goal of treatment is to reach and maintain complete remission, which means:
- Less than 5 percent of cancerous blast cells are present in the bone marrow.
- Blood cell counts have returned to normal.
Treatment options for AMML will depend on the age and overall health of the patient.
Doctors will usually recommend chemotherapy for people with AMML. This treatment involves injecting medication into the bloodstream to kill cancer cells.
During the first stage of treatment, called induction therapy, the chemo is given to destroy cancer cells in the bone marrow and blood.
The induction phase is typically followed by a period of rest.
The next step, known as consolidation therapy, is given to wipe out any cancer cells that are still in the body. Often, this treatment involves higher doses of the drugs.
Older patients or those who aren’t in good health may not be able to tolerate intensive consolidation therapy.
Stem cell transplant
If chemotherapy isn’t successful, a stem cell transplant may be an option for someone with AMML.
First, patients are given high doses of chemo to destroy cancer cells. Then, bone marrow stems cells from a healthy donor are transplanted into the recipient.
While this method can lessen the chances of cancer recurrence, it also poses risks, such as serious infections.
Sometimes, a targeted drug may be added to a patient’s chemotherapy regimen.
In certain circumstances, radiation therapy or surgery may also be appropriate options.
Some people with AMML choose to take part in a clinical trial to gain access to experimental therapies that aren’t available to the public yet. Talk with your doctor if you’re interested in taking part in a research study.
Palliative, or supportive, therapy may be given to improve quality of life and keep people comfortable.
Blood transfusions and antibiotics are some examples of supportive treatment.
To explain your prognosis, your doctor might talk about 5-year survival rates. This refers to the percentage of people who live at least 5 years after diagnosis.
It’s important to remember that these are only estimations. They won’t tell you what will happen in your specific situation.
A person’s individual survival chances will depend on the type of cancer and when it was diagnosed. Additionally, age and general health are factors to consider.
According to the National Cancer Institute, the overall 5-year survival rate for people with all types of AML is
These statistics may be higher or lower depending on the subtype of AML and the mutations involved. For instance, the long-term survival for those with inversion 16 is around 60 to 70 percent.
Additionally, people over age 60 tend to have a poorer prognosis than younger patients.
A note about hope
As newer ways to detect and treat leukemia are being discovered, survival statistics are likely to increase in the future.
Getting a cancer diagnosis can be emotionally difficult. You may experience feelings, such as anger, sadness, and anxiety. The good news is there are resources available to help you through your journey.
In-person or online support groups are a great way to connect with others who also have cancer. You can share stories and tips for managing your physical and mental health. The Leukemia & Lymphoma Society helps patients, family members, and caregivers find support groups in their area.
You may also want to try other methods to help manage stress, such as:
- regular exercise
AMML is a rare type of AML that affects specific white blood cells. It’s usually diagnosed through a bone marrow biopsy and blood test.
Treating the disease can involve chemotherapy, a stem cell transplant, or another approach.
While the survival statistics range from patient to patient, new treatments are on the horizon to effectively target AMML.