Acute myeloid leukemia (AML) is a type of blood cancer in which the bone marrow cannot produce a mature group of myeloid series white blood cells. Myeloid is a type of white blood cell that plays a role in fighting infection and preventing tissue damage. This type of cancer is called acute because the cancer cells grow very quickly or aggressively.
Acute myeloid leukemia is characterized by a high number of myeloblast, which is the forerunner of immature myeloid series white blood cells. This cancer is also known as acute myeloid leukemia or acute myelogenous leukemia.
Causes of Acute Myeloblastic Leukemia
Acute myeloblastic leukemia is caused by mutations or changes in DNA that occur in stem cells or blood stem cells in the bone marrow. This condition causes disruption of the function of the bone marrow in producing healthy blood cells. Instead, the bone marrow produces unhealthy and immature blood cells. Immature blood cells develop rapidly, then crowd out and replace healthy blood cells in the bone marrow. This makes the sufferer susceptible to various types of infections.
There are several factors that increase a person's risk of suffering from acute myeloblastic leukemia, namely:
- Over 65 years of age or older.
- Male gender.
- Active and passive smokers.
- Exposure to harmful chemicals, such as benzene or fomalin.
- A weakened immune system, for example after an organ transplant.
- Blood disorders, such as myelodysplastic syndrome and thrombocytosis.
- Have a genetic disorder, such as Down's syndrome.
- Have had chemotherapy and radiotherapy before.
Symptoms of Acute Myeloblastic Leukemia
Early-stage acute myeloblastic leukemia (AML) has flu-like symptoms, such as fever, loss of appetite, and night sweats. If the leukemia cells have spread to other parts of the body, the symptoms that can appear are:
- Joint and bone pain.
- Blurred vision.
- Balance disorders.
- Easy bruising or rash appears on the skin.
- seizures.
- Nosebleed.
- Swelling or bleeding of the gums.
- Swollen lymph nodes in the neck, groin or armpits.
Diagnosis of Acute Myeloblastic Leukemia
Doctors can suspect a patient has acute myeloblastic leukemia, if there are symptoms, which are confirmed by a physical examination. However, to be sure, sometimes further inspection needs to be done. Among others are:
- blood test, include a complete blood count test to check the number of white blood cells in the body and a peripheral blood smear to check the shape and size of white blood cells, as well as detect immature white blood cells.
- bone marrow aspiration, examination of bone marrow tissue samples. Patients can be diagnosed with acute myeloblastic leukemia, if 20% or more of the blood cells in the bone marrow are immature.
- lumbar puncture, examination of a sample of cerebrospinal fluid, the fluid that surrounds the brain and spinal cord, to detect cancer cells.
- imaging test, to detect infections or other disorders caused by acute myeloblastic leukemia. The types of imaging tests that are performed are:
- ultrasound, to detect swelling that occurs in the liver, lymph nodes, spleen, and kidneys.
- X-ray Photo, to detect infections that occur in the lungs.
- CT scan, to show whether acute myeloblastic leukemia has caused enlargement of the spleen and lymph nodes.
- genetic testing, to detect and examine changes that occur in the chromosomes in cells. This test is also done to determine healing and treatment steps to be carried out.
Treatment of Acute Myeloblastic Leukemia
The treatment for acute myeloid leukemia (AML) consists of two stages, namely:
- Stage 1 - remission induction therapy. At this stage, the patient will undergo chemotherapy to destroy as many cancer cells in the blood and bone marrow as possible. This stage of treatment generally lasts for 3-5 weeks, depending on the patient's condition and the severity of the cancer. However, chemotherapy is usually not able to eliminate all leukemia cells, so further treatment is needed to prevent the leukemia cells from reappearing.
- Stage 2 - consolidation or post-remission therapy. This stage of treatment is carried out to destroy any remaining or remaining leukemia cells during the first stage of chemotherapy. There are several therapies that can be done at this stage, namely:
- advanced chemotherapy,This is done if chemotherapy in the first stage has been able to eliminate most of the cancer cells. Chemotherapy is done to remove the remaining cells and prevent recurrence.
- bone marrow transplant, which is a procedure to renew and repair the bone marrow by introducing healthy blood stem cells into the body to restore the function of the bone marrow to produce healthy blood cells. Healthy blood stem cells can come from the patient himself (autologous) or donated from others (allogeneic).
- targeted therapy, namely therapy using drugs to stop the growth and spread of cancer cells.
- Research stage. If chemotherapy and transplantation treatment methods are not effective and cancer cells reappear, the doctor will provide information about treatment methods that are still in the research stage. Patients are advised to consider first because this method does not guarantee the patient will recover. This treatment method includes the use of drugs or a combination of immunotherapy drugs or other types of cancer drugs.
Complications of Acute Myeloblastic Leukemia
Some complications that can occur due to acute myoblastic leukemia (AML), namely:
- Immune system disorders. The most common complications occur in patients with acute myeloblastic leukemia. This condition can be caused by the disease itself or a side effect of the drugs used while the patient is undergoing chemotherapy.
- Bleeding.Acute myeloblastic leukemia makes the body more susceptible to bruising and bleeding due to thrombocytopenia. Bleeding can occur in the stomach, lungs, to the brain.
- leukostasis, occurs when the number of white blood cells in the bloodstream is very high (>50,000/uL of blood). Leukostasis triggers the clumping of white blood cells which can cause blockage of blood vessels and disrupt the intake of oxygen to the body's cells. This condition results in impaired function of various organs of the body, especially the brain and lungs. Steps to treat leukostasis can be done with chemotherapy and chemotherapy leukapheresis to reduce the number of white blood cells circulating in the body.
In addition to complications from AML, complications can also arise from its treatment. Patients who have undergone high-dose chemotherapy are prone to experiencing infertility or infertility.
Prevention of Acute Myeloblastic Leukemia
The steps to prevent acute myelogenous leukemia are not yet known. Nevertheless, there are some
- Quit smoking.
- Avoid exposure to harmful chemicals, such as benzene, fomalin, and pesticides. If you work in an environment prone to chemical exposure, always use personal protective equipment (PPE) to limit exposure.
- Eat nutritious food.
- Exercise regularly.