Acute myelogenous leukemia, or AML, is a quickly progressing disease in which too many abnormal white blood cells are found in the bone marrow, the soft, spongy center of long bones.
In AML, myeloid stem cells (a type of blood stem cell) become immature white blood cells called myeloblasts or “blasts.” These blasts do not become healthy white blood cells. Instead, they build up in the bone marrow, so there is less room for healthy white blood cells, red blood cells and platelets. In addition, these abnormal cells are unable to fight off infection.
Children with acute myelogenous leukemia are treated at Dana-Farber/Boston Children's Cancer and Blood Disorders Center through our Leukemia Program. Continue reading to learn more about AML or visit the Leukemia Program homepage to learn about our expertise and treatment options for this condition.
Symptoms of AML usually occur over a short period of days to weeks, arising when “blasts” crowd out healthy cells in the bone marrow.
The most common AML symptoms include:
In addition to a complete medical history and physical examination, AML is diagnosed through:
After all tests are completed, doctors will be able to outline the best treatment options.
Treatment for AML usually begins by addressing disease symptoms such as anemia, bleeding or infections. Following that, the most common treatments, which can be used alone or in combination, include:
The first stage of treatment, called the induction stage, is usually a combination of chemotherapy and medications to stop abnormal cells from being made in the bone marrow. Two courses of induction chemotherapy are typically given. This may include chemotherapy delivered to the central nervous system to prevent the spread of leukemia cells to the spinal cord or brain. The goal is remission and may last approximately two months. If remission is not achieved, alternative induction chemotherapy may be given to try to achieve a remission.
The next stage of treatment, called the intensification or consolidation stage, is intended to kill any remaining leukemia cells. In some circumstances, continued chemotherapy is recommended. In other cases, stem cell transplantation may be considered the best option. Radiation therapy may be given as part of conditioning for stem cell transplantation.
Dana-Farber/Boston Children's has one of the largest and most experienced pediatric stem cell transplant programs in the United States. Watch Dr. Leslie Lehmann explain how stem cell transplants work.