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Acute Myeloid Leukemia...
Acute myeloid leukemia (AML) is a fast-growing cancer of the blood and bone marrow. In AML, the bone marrow makes many unformed cells called blasts. Blasts normally develop into white blood cells that fight infection.
However, the blasts are
abnormal in AML. They do not develop and cannot fight infections. The bone
marrow may also make abnormal red blood cells and platelets. The number of
abnormal cells (or leukemia cells) grows quickly. They crowd out the normal
red blood cells, white blood cells and platelets the body needs.
AML is less common than acute lymphocytic leukemia (also called acute lymphoblastic
leukemia or ALL), another form of leukemia that occurs in children. Children
with Down syndrome have an increased risk of AML during the first 3 years of
life. All types of blood cells are produced by the bone marrow. The bone marrow
is the spongy tissue inside the large bones of the body. The bone marrow makes
red blood cells (which carry oxygen and other materials to all tissues of the
body), white blood cells (which fight infection), and platelets (which help make
the blood clot). The bone marrow produces new blood cells. In leukemia the bone
marrow starts producing large numbers of abnormal blood cells usually white blood
cells. These abnormal, immature white blood cells are called blasts. These cells
flood the blood stream and lymph system, and may invade vital organs such as
the brain, testes, ovaries, or skin. Acute promyelocytic leukemia is a rare type
of AML that prevents blood from clotting normally. In rare cases, AML tumor cells
form a solid tumor called an isolated granulocytic sarcoma or chloroma.
Leukemia can be acute (progressing quickly with many immature blasts) or chronic
(progressing slowly with more mature-looking cancer cells). Acute myeloid leukemia
can occur in both children and adults. Treatment is different for adults than
it is for children.
Incidence
Approximately 500 children are diagnosed with acute myeloid leukemia in the
United States each year.
AML is diagnosed in about 20 percent of children with leukemia, but it usually
occurs in people older than 25.
AML is the most common second malignancy (a different
or second cancer found in a patient previously treated for
cancer) in children treated for malignancies.
Certain children are at higher risk for a poor outcome than others:
African American and Hispanic children appear to have a poorer outcome than Non-Hispanic
Caucasian children.
Survival rates in boys tend to be lower than in girls.
Survival rates in infants are improving but they are still poor. The best results
are in children age 1 to 9 years old. Older children may require more aggressive
treatment.
The prognosis may vary depending on other risk factors as well, including the
subtype of the cancer, how high the white blood count is, degree of organ involvement,
and genetic background.
Although children with precursor-B and early precursor-B tend to have a better
prognosis than patients with the B-cell stage and T-cell types of ALL, advances
in treatment are improving the outlook for patients with all these latter types.
Responding well to early treatment is a good sign regardless of the risk category.
The Outlook
Acute lymphocytic leukemia is responsible for about 1,490 deaths a year in the
US, and it can progress quickly if untreated. However ALL is one of the most
curable cancers and survival rates are now at an all-time high. Both the oldest
and very young age groups tend to have lower survival rates, usually because
the leukemia that develops in these patient groups tends to have genetic features
that produce a more severe condition.
However, s urvival rates in children with cancer, and leukemia in particular,
have increased from 53 - 85% in North America over the past 3 decades.
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