• Acute Myelogenous Leukemia (AML) Overview

    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.

    AML Treatment at Dana-Farber/Boston Children's

    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 & Diagnosis

    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:

    • Anemia
    • Bleeding and/or bruising
    • Petechiae – small red spots on the skin
    • Recurrent infections – because immature white blood cells cannot fight infection
    • Bone and joint pain
    • Abdominal pain – because leukemia cells collect in the kidney, liver and spleen, causing organ enlargement

    In addition to a complete medical history and physical examination, AML is diagnosed through:

    • Bone marrow aspiration and biopsy
    • Complete blood count
    • Blood chemistry tests
    • Liver and kidney function tests
    • Chromosomal analysis – to distinguish AML from other types of leukemia
    • Lumbar puncture (spinal tap)

    After all tests are completed, doctors will be able to outline the best treatment options.

    Treatment & Care 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.

    Progressive or Recurrent Disease

    AML relapse can happen during any stage of treatment and may occur months or years after treatment has ended. Recurrent disease is treated with combination chemotherapy or a combination of chemotherapy and stem cell transplant. Clinical trials of new anti-cancer drugs, monoclonal antibodies or stem cell transplants using different sources of stem cells may also be used to treat recurrent AML.

    Long-term Outlook

    The treatment of AML is much more successful than ever before, but the cure rate for childhood AML is still lower than that of other childhood leukemias, especially acute lymphoblastic leukemia. About 80 percent of children achieve remission after their induction treatment. The quicker remission occurs, the more likely children are to have a good prognosis overall.
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  • Stem Cell Transplant

    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.