Acute myelogenous leukemia, or AML, is a type of blood cancer. It 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 through our Hematologic
Malignancy Center's Leukemia Program. Dana-Farber/Boston
Children’s has played a key role in refining treatment for childhood
leukemia, and we continue to be a world leader in leukemia clinical trials designed
to increase cure rates, decrease treatment-related side effects and improve
care for long-term survivors. The Leukemia Program also offers families the
chance to have
their child's leukemia cells molecularly profiled,
which may help identify opportunities for targeted treatment.
Leukemia Program also partners closely with Dana-Farber/Boston Children's Stem Cell
one of the most experienced stem cell transplant centers in the world, to make
stem cell transplantation available to children with AML.
is a blood cancer. It develops in the bone marrow—the soft, spongy center of
the long bones that produces the three major blood cells:
your child has leukemia, two things happen:
common is leukemia?
Leukemia is the most common
form of cancer in children.
It’s important to
understand that leukemias most often occur for no known reason, and in nearly
all cases, its cause cannot be determined. There’s nothing that you could have
done or avoided doing that would have prevented the disease from developing. In
the majority of childhood leukemias, gene mutations and chromosome
abnormalities in the leukemia cells occur by chance. The abnormalities found in
leukemia cells are not found in the other cells of the body.
addition to acute myelogenous leukemia (AML), there are two other types of
leukemia seen in children:
the difference between ALL, AML and CML?
lymphoblastic leukemia (ALL)
myelogenous leukemia (AML)
myelogenous leukemia (CML)
three types all have different leukemia
determines what kind of leukemia my child’s has?
type of leukemia (lymphoblastic or myelogenous) is determined by the type of
marrow cell from which the cancer develops.
causes AML in children?
nearly all cases, it’s not known what causes leukemia. In the majority of
childhood leukemias, gene mutations and chromosome abnormalities in the
leukemia cells occur sporadically (by chance). The abnormalities found in
leukemia cells are not found in the other cells of the body.
there any risk factors associated with AML?
your child has certain genetic syndromes, including Fanconi anemia, Bloom
syndrome, Kostmann syndrome, and Down syndrome, he may be at a higher risk of
developing AML than other children. Myelodysplastic syndrome (MDS) or other forms of
bone marrow disease can also place your child at risk of developing AML, as can
treatment for a previous cancer (though this is rare in children).
leukemia is cancer of the blood-forming bone marrow, the initial symptoms are
often related to abnormal bone marrow function. While each child may experience
symptoms differently, some of the most common include:
AML, these symptoms usually occur over a number of days or weeks.
It’s important to understand that the symptoms of leukemia may resemble other
blood disorders or medical problems. These are common symptoms of the disease,
but do not include all possible symptoms. Always consult your child's physician
for a diagnosis.
are many diagnostic procedures that may be used to determine whether your child
has AML. In addition to a complete medical history and physical examination,
some of these may include:
are a number of treatments that your child’s physician may recommend. Some of
them help to treat the leukemia, while others are intended to address
complications of the disease or side effects of the treatment.
child’s physician will determine a specific course of treatment for childhood
leukemia based on several factors, including:
usually begins by addressing your child’s symptoms, such as anemia, bruising
and/or fever. In addition, treatment may include the following (alone or in
is a drug treatment that interferes with the cancer cell's ability to grow or
reproduce. For some types of cancer, chemotherapy is used alone, while in
others it is used in conjunction with other therapy, such as radiation or
Stem cell transplant
A stem cell (bone marrow) transplant involves the replacement of
diseased bone marrow with another person’s healthy bone marrow.
The success of a transplant
depends on many factors, such as how close the match is between child and donor
(matched siblings provide the closest match; if your child has a sibling, there
is a 1 in 4 chance they will be a match) and the patient's age. The degree to
which your child's bone marrow has failed also factors into the discussion
about whether to pursue a transplant.
The decision to proceed with bone
marrow transplant should be discussed with your child’s doctor and a stem cell transplant team.
Other medicationsOther medications may be given to
prevent or treat damage to other systems of your child’s body caused by
leukemia treatment or for nausea and side effects of treatment.
transfusions replace or supplement your child’s red blood cells and
Your child may be given antibiotics to prevent or treat infections.
child’s health will be closely monitored to determine response to treatment,
detect recurrent disease and manage late effects of treatment.
are the phases of AML treatment in children?
general, phases in the treatment of AML include:
Induction is the first phase
of treatment. It is a combination of chemotherapy and medications given to stop
abnormal cells from being made in the bone marrow.
The goal of this phase is
to induce the cancer to go into remission. This means leukemia cells are no
longer visible under the microscope when examining either the bone marrow or
The induction phase may
last approximately one month and is usually followed by a second course of
induction treatment regardless of whether a remission is achieved. It can be
repeated if remission is not achieved.
However, even when
remission is achieved, leukemia is still present in the body, which is why
further therapy is necessary.
Intensification or consolidation
consolidation is continued treatment to kill any leukemia cells remaining after
induction. In some cases, further chemotherapy is recommended, while in others
we recommend a stem cell transplant.
Your care team will work
with you to determine the best course of treatment.
Our multidisciplinary Leukemia Program ensures in-depth
discussion of each case and personalized treatment plans for every patient.
Your child will receive integrated care from a team that includes the following
addition, our cancer center offers the following services:
Support services to address all of your
child and family’s needs.
child’s prognosis greatly depends on:
can occur during any stage of treatment, even with aggressive therapy, or may
occur months or years after treatment has ended. Overall, between 60 and 70
percent of children treated for AML will be long-term survivors; for some
specific types, the survival rate exceeds 80 percent.
As with any cancer, prognosis and long-term survival can vary greatly. Prompt
medical attention and aggressive therapy are important for the best prognosis,
and continuous follow-up care is essential. New methods are continually being
discovered to improve treatment and decrease side effects of the treatment for
care is important for patients with AML in remission. Our weekly survivorship clinic, which set the national
standard for childhood cancer survivorship care, offers ongoing care to manage
late effects caused by your child’s cancer or the treatment they received.
is a top priority at Dana-Farber/Boston Children's, and our physicians work
continuously to translate laboratory findings into clinical therapies.
research from Dana-Farber/Boston Children's and the Broad Institute of Harvard
and MIT integrates sophisticated interdisciplinary approaches to solve a
molecular mystery that may lead to alternative therapeutic strategies for AML.
The study identifies a previously unrecognized AML target that responds well to
pharmacological inhibition and may be an excellent candidate for use in future
In the area of stem cell transplantation, the Dana-Farber/Boston Children's Stem
Cell Transplant Center is investigating the use of umbilical cord
Also under study is a novel method for preventing graft versus host disease, a
serious complication that occurs when transplanted cells do not recognize the
tissues and organs of the recipient's body and react against the recipient's
tissue. The result of this treatment approach, if it continues to be as
successful, will be that the degree of match between donor and recipient will
not need to be particularly close, greatly increasing the pool of potential
donors for each patient. This could also eliminate the need for long-term drug
therapy traditionally needed to treat graft versus host disease.
possible that your child may be eligible to participate in one of our
Hematologic Malignancy Program's pediatric
leukemia clinical trials.
We also offer access to trials through collaborative groups such as the
Children's Oncology Group (COG), the Pediatric Oncology Experimental
Therapeutics Investigators' Consortium (POETIC) and the Therapeutic Advances in
Childhood Leukemia & Lymphoma (TACL) consortium. Should you have questions
or need advice on whether a particular trial would be appropriate for your
child, email our clinical trials team at firstname.lastname@example.org. We can help you navigate
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.