Acute Myeloid Leukemia: Risk Factors and Treatments

Abstract

Acute myeloid leukemia (AML) is a type of cancer in which the bone marrow makes abnormal white blood cells, red blood cells or platelets. It is also known as acute myelogenous leukemia, acute myeloblastic leukemia, acute granulocytic leukemia ,and acute nonlymphocytic leukemia. This type of cancer can get worse if it is not treated. The leukemia cells can spread outside the blood to other parts of the body

Leukemia refers to cancers that start in the cells that would normally develop into different types of blood cells. Offen, leukemia starts in the forms of the white cells, but others might start in other blood cell types. Acute myeloid leukemia begins in the bone marrow. The soft inner parts of  the bones. This cancer happens because the bone marrow cells do not mature the way they are supposed to. These immature cells are called blast cells. Though, it has different symptoms when a certain part is affected and different methods of treatment.

In the early stages of AML, since the body makes fewer healthy blood cells, the person might feel like have the flu or another illness. Those symptoms can include tiredness, fever, loss of appetite, weight loss and night sweats. Moreover, the symptoms can depend on the kind of blood cell that is affected. For instance, in the case is the red blood cell, the patient can have tiredness, weakness, pale skin, irregular heartbeat, dizziness, cold hands ,and feet. It can also be if they are shortness of breath, any headaches, weight loss, or loss of appetite. If it is the white blood cell affected, it can include fever, weakness, achy muscles, fatigue an,d diarrhea. fewer white blood cells than normal,  “may get infections than usual; these infections may take a long time to get better” ( WebMD, 2017).  Equally, if it is the platelets, the blood might not clot as wells at is suppose to so it can make the person have easy bruising, bleeding that can be hard to stop, bleeding in the gums and  small red spots under the skin caused by bleeding and sore that won’t heal. Furthermore, when the acute myeloid leukemia is spread to different organs of the body. It can spread to the skin. If it spread to the skin, they can cause lumps. It is like a

tumor-like collection under the skin, usually called chloroma. Sometimes, this symptom cannot  identify the AML because at this stage there are no leukemia cells in the bone marrow. When it spread to the gums. It can cause swelling, pain ,and bleeding. Additionally, less often, leukemia cells can spread to other organs. Spread to the brain and spinal cord can cause symptoms such as headaches, weakness, seizure, vomiting, trouble with balance, facial numbness and blurred vision.

Scientists do not know how someone can get AML, but they do know some risk factors for the conditions. Those include smoking, exposure to certain chemicals, pesticides, ionizing radiation or cleaning products such as detergents and mitoxantrone. It can also be if they exposure to high doses of radiation. But the most common risk factor is if a parent, brother or sister has had acute myeloid leukemia. Moreover, fever, shortness of breath and unusual bruising can be a sign of acute myeloid leukemia. Usually, an oncologist or a hematologist who diagnose and treat leukemia. The doctor will do a physical exam first and will check the person for signs of cancer such as bruising and spots of blood under the skin. Afterward, a test for AML will be done. Since this type of cancer affects the immature blood cells called stem cells that grow in the white blood cells, red blood cells ,and platelets. These tests look for immature cells in the blood into the bone marrow. It includes the blood tests, bone marrow tests, lumbar puncture, imaging test ,and gene tests. In the blood test, the doctor will use a needle to take a sample of blood from a vein in the arm. By this procedure, it can help diagnose AML because it does a complete blood count( CBC), with AML there will be more white blood cells and fewer red blood cells and platelets. Also, this test will help do a peripheral smear. It checks the number, shape ,and size of the white blood cells and the look of immature white blood cells known as blasts. As well as, the bone marrow test, the doctor will take a sample with a needle into a bone by the hip and remove fluid or a small piece of bone. If the results are 20 % or more of the blood cells of the bone is immature, then the person is diagnosed with AML.  The lumbar puncture tests, it is to take a sample of cerebrospinal fluid(CFS) and examine it for leukemia cells. The imagine tests, use radiation, sound waves and magnets to take pictures inside the body. This test is not specific to diagnose AML but it helps the doctor know if is causing any type of infection. Lastly, the gene tests can help figure out if there is any gene changes in the blood or bone marrow. However, this method of tests help the doctor find the treatment that is most likely to work with their cancer.

Without treatment it can be a life-threatening because is acute. It fast-growing the progresses quickly without treatment. It can spread to the blood and to other parts of the body, such as the lymph bndes, the liver, the spleen , the brain and spinal cord and the testicles for men. However, in each person is different and how the acute myeloid leukemia affects them depending on certain things; it can include how well the cancer responded to the treatment. Whatsoever, a better outlook if the patient is younger than 60. According to the American Psychological Assoc., it states that “ median age of diagnosis is 68 years, with approximately 40% of patients diagnosed at younger than age 60 years”(Roberts, Mms. D, 2019). Also, if they  have a lower white blood cell count when they are diagnosed. Also, if they do not have a history of blood disorders or cancer or any gene mutations or chromosomal changes. Likewise,  several different treatment the work on AML is chemotherapy, stem cell transplant, radiation and targeted therapy.  Regardless, the goal of this treatment is to put the person in remission, which means they do not have any symptoms of cancer. The treatment has two phases. Phase 1 is the remission induction therapy. It is a high doses of chemotherapy to destroy as many leukemia cells as possible. The patient might need to stay for 3 to 5 weeks in the hospital so the patient can treat any side effects.Based from studies, “ the resistance of leukemia cells to chemotherapy drugs becomes the main obstacle in the treatment of AML”( Zhang, J., 2019). The chemotherapy side effects can include nausea, hair loss, mouth sure, fatigue, loss of appetite, diarrhea, easy bruising and risk for an infection. Afterward, the bone marrow will start to make healthy blood cells. Phase 2 is the post-remission therapy. It uses more treatment to wipe out any cancer cells that might be left after chemotherapy. In phase 2, there are options to help the process. Chemotherapy cycle on high-dose, allogeneic stem cell transplant from a donor or autologous stem cell transplant from the patient itself.

Unfortunately, treating acute myeloid leukemia can take a roll and the person might get tired and be concerned about what the future holds. For this reason, some tips that help the patient feels better is to eat healthily. Nutritious food can make fell stronger and healthier and can speed the recovery. Protein can help the body heal and strengthen the immune system. In this case, it will get it from fish, eggs, peas, soy ,and lean red meat.

References

• Roberts, Mms. D., Langston, A. A., & Heffner, L. T. (2019). Acute Myeloid Leukemia in Young Adults: Does Everyone Need a Transplant? Journal of Oncology Practice, 15(6), 315–320. https://doi.org/10.1200/JOP.18.00574
• Zhang, J., Gu, Y., & Chen, B. (2019). Mechanisms of drug resistance in acute myeloid leukemia. OncoTargets & Therapy, 12, 1937–1945. https://doi.org/10.2147/OTT.S191621
• WebMD. (2017, March 16). What Are the Symptoms of Acute Myeloid Leukemia?. Retrieved from https://www.webmd.com/cancer/lymphoma/acute-myeloid-leukemia-complications#1