Myeloblastic leukemia. Myeloid leukemia - what is it? Chronic myeloid leukemia: causes, treatment, prognosis

By multiplying and accumulating in the bone marrow, they interfere with the production and functioning of normal blood cells, which causes the main symptoms of the disease.

As you know, different blood cells develop differently and have different precursors - that is, they belong to different lines of hematopoiesis (see diagram in the article “Hematopoiesis”). The line of hematopoiesis leading to the appearance of lymphocytes is called lymphoid; the rest of the leukocytes and other blood cells belong to myeloid lines. Accordingly, leukemias are distinguished from the precursor cells of lymphocytes (such leukemias are called lymphoblastic, lymphocytic, or simply lymphocytic leukemias) and from the precursors of other cells (such leukemias are called myeloblastic, myeloid, or simply myeloid leukemias).

Acute myeloid leukemia (AML, acute myeloid leukemia, acute myeloid leukemia, acute non-lymphoblastic leukemia) is a disease that is relatively rare in children, but its frequency increases with age. The term "acute" refers to the rapid progression of the disease, as opposed to chronic leukemia. The term "myeloid" means, as stated above, that the immature cells that form the basis of the disease belong to the so-called myeloid lineage of hematopoiesis. These cells are usually myeloblasts and their descendants, but other types of blast cells may also be present.

Within the framework of the French-American-British morphological classification (FAB), 8 main variants of AML are distinguished.

Some very rare types of AML are not included on this list. Variants of AML from M3 to M7, which have their own names and some specific features, are discussed in more detail in separate sections of our reference book.

Frequency of occurrence, risk factors

AML accounts for about 15% of all cases of cancer of the hematopoietic system in children, that is, it occurs much less frequently in them than acute lymphoblastic leukemia. Among children under 14 years of age, the incidence of AML is approximately 0.6-0.8 cases per 100 thousand people per year, but after the age of 40-45 years there is a sharp rise in incidence. Most patients with AML are elderly. In contrast to what is most typical for childhood, with AML, children make up only 10% of patients.

In most cases of AML, it is impossible to name the direct cause of the disease. However, some factors increase the likelihood of developing AML: exposure to a number of chemical drugs, ionizing radiation (including during previous treatment of other cancers), and sometimes cases of AML among close relatives, which indicates a certain role of genetic predisposition.

The development of AML may be preceded by certain diseases of the hematopoietic system, such as myelodysplastic syndrome. Finally, the risk of AML is increased in certain genetically determined abnormalities, including Down syndrome, Fanconi anemia, and some other conditions.

Signs and symptoms

AML is characterized by many different features and may present differently in different patients. The leading signs, as a rule, are anemia: fatigue, pallor, shortness of breath, decreased appetite. A lack of platelets is manifested by increased bleeding from cuts and bruises, nosebleeds, and the “unreasonable” appearance of bruises and hemorrhages. Treatment-resistant infections often occur because the patient has too few “normal” (mature, functional) white blood cells to fight them. Damage to the mucous membranes of the mouth and gastrointestinal tract and swelling of the gums may occur. Body temperature is often elevated and bone pain occurs. Sometimes tumors arise from leukemia cells outside the bone marrow - myelosarcoma (chloroma).

Since most symptoms can be associated with other diseases and are not specific to AML, before starting treatment it is necessary to clarify the diagnosis based on laboratory methods, which is urgently carried out in a hospital setting.

Diagnostics

With AML, changes occur in the usual clinical blood test: a lack of red blood cells and platelets, most often an excess of white blood cells, many of them represented by immature forms. But a reliable diagnosis can only be made by examining a bone marrow sample. According to the World Health Organization criteria, the diagnosis of AML is made if the myeloblast content in the bone marrow is at least 20% (according to the French-American-British FAB classification, the threshold value is 30%).

To treat and assess the prognosis of the disease, it is important not only to confirm the diagnosis of leukemia, but also to distinguish between acute lymphoblastic leukemia and AML, to distinguish between leukemia and myelodysplastic syndrome, and also to determine the specific variant of AML (see). For this purpose, not only morphological examination of cells is used (microscopic examination of specially stained preparations), but also cytochemical analysis, as well as immunophenotyping (study of antigen proteins on the surface of cells). Cytogenetic studies are used to detect chromosomal rearrangements - so-called translocations, which are of great importance for determining the variant of the disease and prognosis.

Accurate diagnosis of AML and its variants is sometimes challenging, requiring the participation of highly qualified hematologists and hemopathologists in the diagnostic process.

The risk group is determined by many factors. Let's list some of them:

Age: Middle-aged and elderly patients have a worse prognosis on average than children and young adults.
Chromosomal changes in leukemic cells. Thus, translocations t(15;17) or t(8;21) determine a lower risk in patients. At the same time, for example, certain changes in chromosomes 5 and 7 are associated with a worse prognosis.
Variant of leukemia. Some variants of AML (such as M0, M6, M7) are associated with a high risk, and some, on the contrary, respond relatively well to modern therapy (AML M3).
A higher risk is associated with secondary leukemia that occurs against the background of another hematological disease - such as myelodysplastic syndrome or Fanconi anemia - or after undergoing treatment (chemotherapy, radiation) for a malignant tumor. The risk also increases sharply when leukemia relapses.

Treatment

The main treatment for AML is chemotherapy. As with acute lymphoblastic leukemia, treatment includes remission induction and consolidation phases; Sometimes maintenance therapy is also used.

Induction of remission– intensive therapy aimed at achieving remission of leukemia. In most types of AML, induction of remission is carried out using intensive chemotherapy using cytarabine (Cytosar) and anthracycline drugs (daunorubicin, idarubicin), sometimes with the addition of other drugs - for example, etoposide or mitoxantrone. The standard is “7+3” courses, in which the patient is administered cytarabine for 7 days, and for three days - in combination with an anthracycline drug.

A specific feature of therapy for acute promyelocytic leukemia (AML M3) is the use of the drug ATRA (all-trans retinoic acid, tretinoin).

If, as a result of induction therapy, it turns out that there are less than 5% blast cells in the bone marrow and the patient has no other manifestations of the disease (including signs of neuroleukemia), then remission is stated.

As a result of induction courses, remission can be achieved in the vast majority of patients. However, the achieved remission cannot be sustained without therapy consolidation, that is, consolidation of remission. In the consolidation phase, residual amounts of abnormal blast cells are destroyed to avoid relapse of the disease. The most important drug in the consolidation phase of AML treatment is cytarabine, often in high doses; Daunorubicin, 6-mercaptopurine, ifosfamide, mitoxantrone, etoposide, etc. are also used in different combinations.

During the induction and consolidation stages, intravenous administration of chemotherapy drugs is carried out in a hospital setting.

Maintenance therapy is not used in all cases (unlike acute lymphoblastic leukemia), but in the M3 AML variant it is important. This therapy is less intensive than induction and consolidation therapy and does not require a hospital stay.

Neuroleukemia is less common in AML than in acute lymphoblastic leukemia. Most often it occurs in AML variants M3, M4 and M5. For its treatment and prevention, cytarabine, methotrexate and glucocorticosteroids administered intrathecally, through lumbar puncture of the spinal canal. Radiation to the head (cranial radiation) may also be used occasionally. Children are at higher risk of leukemia spreading to the central nervous system than adults, so prophylactic chemotherapy is used more often to prevent it.

To reduce the chance of relapse, high-risk patients may be eligible for a bone marrow transplant. Indications for transplantation may include, for example,

translocations and other cytogenetic changes in leukemic cells associated with high risk,
relapse of leukemia,
development of AML due to myelodysplastic syndrome or other blood disease, as well as after previous treatment of malignant tumors.

The likelihood of transplant success is greatest if performed after the first remission has been achieved. Transplantations are performed more frequently in children than in adults and are, on average, more successful.

During intensive chemotherapy for AML, normal hematopoiesis is almost always suppressed to some extent. Therefore, many AML patients require transfusions of blood components: platelets to prevent bleeding and red blood cells to treat anemia. Transfusions of donor leukocytes (granulocytes) are needed only in cases of severe infectious complications.

Since both leukemia itself and the chemotherapy used in its treatment sharply reduce the body’s resistance to various infections, patients during treatment often need effective antibacterial, antifungal and antiviral drugs for the prevention and treatment of infectious complications. Both common and opportunistic infections pose a danger. In particular, fungal infections such as candidiasis and aspergillosis pose a serious problem.

Treatment of AML imposes restrictions on the patient's lifestyle. During intensive chemotherapy, it is necessary to follow a diet and strict hygiene rules, as well as minimize contact with the outside world to avoid infections. Doctors and nurses tell each patient what he can and cannot do at the current stage of treatment.

The total duration of treatment for various forms of AML ranges from several months to 2-3 years.

Forecast

Without treatment, AML usually leads to the death of the patient within several months, sometimes even several weeks. However, with modern treatment many can be saved. The prognosis depends on the specific type of myeloid leukemia, cytogenetic features (i.e., the chromosomal structure of leukemic cells), age, general condition of the patient and other factors.

Currently, about 50-60% of children with AML recover. In middle and old age, unfortunately, the results are worse.

It should be noted that the majority of patients with AML are elderly patients. Compared to young people, they tolerate treatment more difficultly and respond less well to it. Only 5-15% of patients over 60 years of age achieve long-term remission. For the rest, supportive treatment (fighting infections, transfusions of blood components, pain relief) often becomes the main thing to slightly prolong life and improve its quality.

– a malignant disease of the blood system, accompanied by the uncontrolled proliferation of altered leukocytes, a decrease in the number of red blood cells, platelets and normal leukocytes. It manifests itself as an increased tendency to develop infections, fever, fatigue, weight loss, anemia, bleeding, the formation of petechiae and hematomas, pain in bones and joints. Sometimes skin changes and swelling of the gums are detected. The diagnosis is made based on clinical symptoms and laboratory data. Treatment is chemotherapy, bone marrow transplantation.

ICD-10

C92.0

General information

Acute myeloid leukemia (AML) is a malignant lesion of the myeloid blood lineage. Uncontrolled proliferation of leukemia cells in the bone marrow leads to the suppression of other blood sprouts. As a result, the number of normal cells in the peripheral blood decreases, anemia and thrombocytopenia occur. Acute myeloid leukemia is the most common acute leukemia in adults. The likelihood of developing the disease increases sharply after age 50. The average age of patients is 63 years. Men and women of young and middle age suffer equally often. In the older age group, there is a predominance of males. The prognosis depends on the type of acute myeloid leukemia, with five-year survival rates ranging from 15 to 70%. Treatment is carried out by specialists in the field of oncology and hematology.

Causes of acute myeloid leukemia

The direct cause of the development of AML is various chromosomal abnormalities. Risk factors contributing to the development of such disorders include unfavorable heredity, ionizing radiation, contact with certain toxic substances, taking a number of medications, smoking and blood diseases. The likelihood of acute myeloid leukemia increases with Bloom's syndrome (short stature, high voice, characteristic facial features and a variety of skin manifestations, including hypo- or hyperpigmentation, skin rash, ichthyosis, hypertrichosis) and Fanconi anemia (short stature, pigmentation defects, neurological disorders, abnormalities of the skeleton, heart, kidneys and genital organs).

Acute myeloid leukemia quite often develops in patients with Down syndrome. Hereditary predisposition can also be traced in the absence of genetic diseases. With AML in close relatives, the likelihood of developing the disease increases 5 times compared to the population average. The highest level of correlation is found in identical twins. If acute myeloid leukemia is diagnosed in one twin, the risk in the other is 25%. One of the most important factors provoking AML are blood diseases. Chronic myeloid leukemia in 80% of cases transforms into an acute form of the disease. In addition, AML is often the outcome of myelodysplastic syndrome.

Ionizing radiation causes acute myeloid leukemia when the dose exceeds 1 Gy. The incidence increases in proportion to the radiation dose. In practice, staying in areas of atomic explosions and accidents at nuclear power plants, working with radiation sources without appropriate protective equipment, and radiotherapy used in the treatment of certain cancers are important. The cause of the development of acute myeloid leukemia upon contact with toxic substances is bone marrow aplasia as a result of mutations and damage to stem cells. The negative effects of toluene and benzene have been proven. Typically, AML and other acute leukemias are diagnosed 1-5 years after exposure to the mutagen.

Among the drugs that can provoke acute myeloid leukemia, experts name some drugs for chemotherapy, including DNA topoisomerase II inhibitors (teniposide, etoposide, doxorubicin and other anthracyclines) and alkylating agents (thiophosphamide, embiquin, cyclophosphamide, chlorambucil, carmustine, busulfan). AML can also occur after taking chloramphenicol, phenylbutazone and arsenic drugs. The share of drug-induced acute myeloid leukemia is 10-20% of the total number of cases of the disease. Smoking not only increases the likelihood of developing AML, but also worsens the prognosis. The average five-year survival rate and duration of complete remissions are lower for smokers than for non-smokers.

Classification of acute myeloid leukemia

The WHO classification of acute myeloid leukemia is very complex and includes several dozen types of the disease, divided into the following groups:

AML with typical genetic changes.
AML with changes due to dysplasia.
Secondary acute myeloid leukemia resulting from treatment of other diseases.
Diseases with myeloid lineage proliferation in Down syndrome.
Myeloid sarcoma.
Blastic plasmacytoid dendritic cell tumor.
Other types of acute myeloid leukemia.

Treatment tactics, prognosis and duration of remissions for different types of AML can vary significantly.

Symptoms of acute myeloid leukemia

The clinical picture includes toxic, hemorrhagic, anemic syndromes and the syndrome of infectious complications. In the early stages, the manifestations of acute myeloid leukemia are nonspecific. There is an increase in temperature without signs of catarrhal inflammation, weakness, fatigue, loss of weight and appetite. With anemia, dizziness, fainting and pallor of the skin occur. With thrombocytopenia, increased bleeding and petechial hemorrhages are observed. Possible formation of hematomas with minor bruises. With leukopenia, infectious complications arise: frequent suppuration of wounds and scratches, persistent repeated inflammation of the nasopharynx, etc.

Induction programs can achieve remission in 50-70% of patients with acute myeloid leukemia. However, without further consolidation, most patients relapse, so the second stage of treatment is considered an obligatory part of therapy. The consolidation treatment plan for acute myeloid leukemia is drawn up individually and includes 3-5 courses of chemotherapy. In case of a high risk of relapse and already developed relapses, bone marrow transplantation is indicated. Other treatments for recurrent AML are still in clinical trials.

Prognosis of acute myeloid leukemia

The prognosis is determined by the type of acute myeloid leukemia, the age of the patient, and the presence or absence of a history of myelodysplastic syndrome. The average five-year survival rate for various forms of AML ranges from 15 to 70%, the probability of relapses ranges from 33 to 78%. Elderly people have a worse prognosis than younger people, which is explained by the presence of concomitant somatic diseases, which are a contraindication for intensive chemotherapy. With myelodysplastic syndrome, the prognosis is worse than with primary acute myeloid leukemia and AML that arose during pharmacotherapy for other cancers.

Acute myeloid leukemia results from genetic abnormalities that cause tumor-proliferating blood cell precursors. The process of cell reproduction and maturation becomes unstable, which causes a predominance of myeloblasts, immature forms of blood cells, in the bone marrow.

Acute myeloid leukemia– This is the most common type of leukemia in children, but the risk of the disease increases with age.

Causes of acute myeloid leukemia

Doctors mainly point to genetic reasons for the development of myeloid leukemia, which cause transformation of stem cells.

In addition, this type of leukemia most often occurs in cases of chromosomal aberrations, for example in patients with Down syndrome (trisomy 21) or Klinefelter syndrome (an extra X chromosome in men, for example, XXY).

The etiology is difficult to determine, but risk factors include:

radiation;
radiotherapy;
exposure to chemicals such as benzene or mustard gas;
completed chemotherapy for the treatment of cancer and lymphoma.

The disease occurs mainly in adults and comprises 60% of acute leukemias. According to statistics, per year at the age of 30-35 years, on average, 1 person per 100,000 falls ill, and at the 65th year of life the rate increases to 10/100,000.

Symptoms and course of acute myeloid leukemia

Acute myeloid leukemia begins suddenly. The symptoms are quite nonspecific, so it is difficult to make an immediate diagnosis.

The following disorders are characteristic:

weakness and exhaustion of the body;
feverish conditions;
night sweats;
pain in bones and joints;
pale skin;
penetration of leukemia cells into internal organs and lymph nodes;
the presence of black or blue bruises for no apparent reason;
small petechiae;
easy fatigue, feeling of shortness of breath during physical activity;
weight loss;
leukemic gap - the absence of intermediate forms in the development of leukocytes in the peripheral blood;
susceptibility to yeast and bacterial infections;
bleeding from the nose or gums due to low platelet levels;
enlargement of the spleen and lymph nodes, less often the liver.

Acute myeloid leukemia has a generally severe course. Currently, the average life expectancy for people after diagnosis is 10-16 months. Previously, the patient would die within a few weeks. Relapses occur most often during the first year of the disease.

Patients with acute myeloid leukemia often die from sepsis, bleeding in the central nervous system and dysfunction of internal organs.

Diagnosis of acute myeloid leukemia

The diagnosis of myeloid leukemia is made based on the patient's symptoms and test results. Blood morphology and bone marrow biopsy are performed. The blood usually contains an increased number of white blood cells, and thrombocytopenia and anemia may also occur.

A typical result is an increase in the number of leukocytes to 800 thousand per mm 3 or a decrease in their number to 1 thousand per mm 3. The smear reveals blastic cells.

Cytogenetic, immunophenotypic and molecular studies serve to confirm the diagnosis.

The differential diagnosis includes, but is not limited to, ruling out diseases such as infectious mononucleosis, acute lymphoblastic leukemia, and chronic myelogenous leukemia. After diagnosis, isolation of the patient is necessary to protect against infections. The individual treatment steps are then introduced.

Treatment of acute myeloid leukemia

Several subtypes of the disease can be distinguished (depending on morphological, immunophenotypic and cytochemical features). Depending on the type of acute myeloid leukemia, different forms of therapy are used.

Treatment of acute myeloid leukemia is expected to lead to remission of the disease. This is done using chemotherapy, which kills as much cancer cells as possible. Apply cytostatic drugs, and treatment is carried out in specialized hematological centers.

The next stage of treatment is consolidation, the goal of which is to maintain remission and prevent relapse of the disease. Patients at high risk of relapse undergo bone marrow transplantation, while patients at low risk of relapse or who are elderly are treated for approximately 2 years.

Prevention and treatment of infections, bleeding diathesis, anemia and metabolic disorders are also very important. Psychological support is also important.

Prognosis for acute myeloid leukemia

The prognosis depends on the age of the patient (with age the prognosis is worse), on the cytogenetic and molecular type of leukemia, on the response to treatment and the presence of extramedullary changes.

Greatest chance for cure leukemia young people have. Relapses most often occur in the first year of treatment and decrease over time. Bone marrow transplantation leads to a cure in more than 60% of patients, the use of chemotherapy alone gives results in only 10-15% of patients, and its intensification can raise this figure to 40%.

In acute myeloid leukemia, white blood cells known as granulocytes or monocytes become cancerous. The disease usually develops quickly, over several days or weeks.

Acute myeloid leukemia is a rare disease. The risk of developing it increases with age. This is the most common type of leukemia in adults. It is most often diagnosed in older people over sixty-five years of age.

Causes of acute myeloid leukemia

Researchers identify risk factors such as:

Exposure to radiation and radon. Radiotherapy increases the risk of acute leukemia. Radon, a naturally occurring radioactive gas, has been implicated in a number of studies as a contributing factor.
Smoking increases the chance of AML by two to three times. The presence of benzene in cigarette smoke is one of the main reasons.
The influence of benzene during work activities is named as one of the risk factors.
Some hereditary diseases (Fanconi anemia, Down syndrome) increase the risk of AML.
Chemotherapy for lymphoma or breast cancer increases the likelihood of AML, namely the use of drugs such as chlorambucil, melphalan or cyclophosphamide.
Certain blood disorders increase the risk of acute myloid leukemia: myelodysplastic syndrome, myeloproliferative disorders.
Autoimmune diseases - rheumatoid arthritis, autoimmune hemolytic anemia and ulcerative colitis increase the likelihood of AML by 8 times, compared with those people who do not have these disorders.
A review (meta-analysis) of 21 studies found that drinking alcohol during pregnancy increases the risk of AML in children.
A number of studies have identified excess weight as a risk factor when the body mass index is more than 30 or higher.

Symptoms of acute myeloid leukemia

Many signs of acute myeloid leukemia are vague and nonspecific. A person may experience flu-like symptoms:

general weakness;
increased fatigue;
fever;
weight loss;
private infections;
easily acquired bruises and bleeding;
blood in urine and stool;
pain in bones and joints;
shortness of breath;
enlarged lymph nodes (rare);
discomfort due to a swollen liver or spleen.

These manifestations are a consequence of an excess number of leukemia cells and a lack of healthy blood cells of all groups.

Fatigue is a consequence of low red blood cell levels (anemia). Shortness of breath may also occur.

People easily develop infections due to a lack of healthy white blood cells that can fight bacteria and viruses. The disease lasts a long time and is difficult to get rid of.

A lack of platelets causes problems with blood clotting. The result is bleeding and bruising. Women have very difficult periods.

The accumulation of leukemia cells in bones, joints or lymph nodes due to their excess amounts causes pain and swelling.

Types of AML

Acute myeloid leukemia is divided into subtypes. Doctors plan cancer treatment based on the specific subtype of AML.

One of the classifications is FAB - the French-American-British system. The type of leukemia here depends on how the leukemia cells look under a microscope, as well as the antibody markers on the abnormal cells.

There are 8 types according to the FAB system:

M0, M1 and M2 are myeloid leukemia, which accounts for more than half of all cases of the disease.

M3 – promyelocytic leukosis – 10% in adults with AML.

M4 – acute myelomonocytic leukemia – 20%.

M5 – acute monocytic leukemia – 15%.

M6 - acute erythroleukemia and acute megakaryocytic leukemia are very rare types.

The WHO classification divides AML into groups depending on how abnormal the cell has become:

There are mutations in the chromosomes of leukemia cells.
Acute myeloid leukemia developed from a blood disease.
More than one type of blood cell has abnormalities.
AML developed after cancer treatment.

Pathologists examine leukemia cells under a microscope to determine which WHO or FAB group a particular case belongs to. Tests are also performed for specific proteins produced by abnormal cells (immunophenotyping) and mutations in chromosomes (cytogenetic tests).

Rare types

Granulocytic sarcoma is an AML in which tumor cells can be found outside the bone marrow. They can appear in any part of the body.
Mixed types. Some leukemias may be a mixture of AML and ALL - acute biphenotypic leukemia.

Get a doctor's consultation

Diagnosis of acute myeloid leukemia in Assuta

A hematologist, a specialist in the diagnosis and treatment of blood diseases, works with the patient. Suggested tests may include:

Blood tests for myeloid leukemia. This is the most important test that determines the FBC subtype of AML. Many patients with acute myeloid leukemia have low white blood cell counts. A high white blood cell count may be due to a large number of immature white blood cells called blast cells or blasts. Tests may also be performed to check the health of your kidneys and liver.
A bone marrow examination involves two tests: aspiration and biopsy. Aspiration involves removing fluid with a thin needle from the thigh bones and applying a local anesthetic. A biopsy uses a larger needle and the doctor removes a small amount of bone and bone marrow. A test is performed simultaneously for mutations in chromosomes (cytogenetic) and specific proteins created by leukemia cells (immunophenotyping).
A chest x-ray is necessary to check your general health.

Further diagnosis of acute myeloid leukemia in Assuta

Blood tests will be necessary during and after treatment. So, for example, if an infection is suspected, the doctor will order a test to find out what types of antibiotics the patient needs. In addition, blood is taken to check the functioning of the liver and kidneys.

Bone marrow testing will be performed at various times throughout treatment and follow-up. These tests can help:

Determine the exact type of acute myeloid leukemia.
To establish the effectiveness of cytostatic treatment.
Check for abnormal cells after completion of therapy.
Perform a minimal residual disease test.

HLA (tissue) typing

This examination is ordered if a donor bone marrow transplant is considered as a suitable option. Using blood tests, tissue compatibility is determined. Leukocytes have proteins on their surface - HLA markers. Through tissue typing, doctors find out how similar tissues are to reduce the likelihood of rejection.

Search for abnormal cells after treatment

Doctors call the small number of leukemia cells remaining after treatment as minimal residual disease. Blasts are not found in blood tests or bone marrow samples. Two tests are used to detect them.

PCR (polymerase chain reaction) by identifying genetic mutations finds one leukemia cell among a million healthy ones.

Immunophenotyping detects proteins made by abnormal cells. These two tests show how well the chemotherapy worked and whether the disease has relapsed.

Prognosis for acute myeloid leukemia

General information is provided here for your reference. Only the attending physician can provide more accurate information taking into account individual factors. The terms 5-year and 10-year survival rate refer to the number of people in the studies who were alive 5 and 10 years after diagnosis and treatment. In addition, these are statistics based on which the treatment was carried out several years ago. Treatment methods are improving every year, so treatment now offers better prospects.

The prognosis of acute myeloid leukemia is influenced by factors such as:

the body's response to chemotherapy;
how widespread the disease was at the time of diagnosis;
type of leukemia.

The result also depends on whether there was leukemia that transformed from chronic to acute. This complicates the treatment process.

In addition, leukemia that develops as a result of treatment for another type of cancer is more difficult to treat. Secondary leukemia usually develops within 10 years after treatment of the first malignant disease.

Doctors, even if they cannot cure the disease, are able to keep leukemia in remission for several years. When AML relapses, in some cases it is possible to achieve a second remission through chemotherapy treatment.

Prospects for AML

Age is one of the most important prognostic factors. A young body copes much better with very intensive therapy.

Overall, 20% of AML patients experience 5-year survival across all ages. More detailed information on 5-year survival rates based on age:

14 years and younger – for 66%.
15-24 years – for 60%
25-64 years old – for 40%.
65 years and older – for 5%.

Apply for treatment

Blood diseases are always very dangerous for humans. First, blood comes into contact with all tissues and organs inside the body. To perform its functions of saturating cells with oxygen, nutrients and enzymes, blood circulation must function correctly and cellular composition must be within normal limits.

Secondly, blood cells ensure the functioning of the body's immune system. Acute myeloblastic leukemia disrupts the structure of cells and causes a decrease in immunity.

Acute myeloid leukemia (AML) develops when immature cells called blasts undergo changes. At the same time, the body lacks mature elements, while the pathological form of blast transformation increases at high speed. The process of changing cellular structure is irreversible and cannot be controlled with medications. Acute myeloid leukemia often leads to the death of the patient.

The cell change affects one of the types of white blood cells, granulocytes, which is why there is a common popular name “leucemia”. Although, of course, the color of the blood does not change during the disease. Leukocyte cells that have granules (granulocytes) undergo changes.

Chronic myeloid leukemia (CML) occurs when the cellular structure of mature granulocytes undergoes a change. During this pathology, the body's bone marrow is able to produce new cells that mature and turn into healthy granulocytes. Therefore, chronic myeloid leukemia does not develop as quickly as acute leukemia.

A person may not be aware of changes in white blood cells for years.

Myeloid leukemia is a very common disease among blood diseases. For every 100 thousand people there is 1 patient with leukemia. This disease affects people regardless of race, gender and age. However, according to statistics, leukemia is more often diagnosed in 30-40 year old people.

Causes of the disease

There are medically proven reasons for the appearance of changes in granulocytes. Chronic myeloid leukemia has been studied for many years and many factors have been identified that cause leukemia. However, medicine cannot offer treatment that could cure the patient with 100% probability. Leukemia, leukemia, what is it?

Doctors call the main cause of the development of myeloid leukemia a chromosomal translocation, which is also known as the “Philadelphia chromosome.” As a result of the disorder, sections of the chromosomes change places and a DNA molecule with a completely new structure is formed. Then copies of malignant cells appear and the pathology begins to spread. Myeloid tissue is used to make white blood cells. The blood cells then change and the patient develops myeloid leukemia.

The following factors may predispose to this process:

Radiation exposure. The harmful effects of radiation on the body are widely known. People may be exposed to radiation in areas of man-made disasters and in some production areas. But more often, myeloid leukemia becomes a consequence of previous radiation therapy against another type of cancer.
Viral diseases.
Electromagnetic radiation.
The effect of some medications. Most often we are talking about drugs against cancer, since they have an intense toxic effect on the body. Ingestion of certain chemicals can also lead to myeloblastic leukemia.
Hereditary predisposition. People who inherited this ability from their parents are more likely to experience DNA changes.

Acute symptoms

During the acute course of the disease, leukocyte cells change and multiply at an uncontrolled rate. The rapid development of cancer leads to the appearance of such signs of the disease that a person cannot ignore. Acute myeloblastic leukemia manifests itself with severe malaise and pronounced symptoms:

One of the first characteristic signs of leukemia is pale skin. This symptom accompanies all diseases of the hematopoietic system.
A slight increase in body temperature within 37.1–38.0 degrees, excessive sweating during night rest.
A rash appears on the skin in the form of small red spots. The rash does not cause itching.
Acute myeloid leukemia causes shortness of breath even with mild physical exertion.
A person complains of pain in the bones, especially when moving. However, the pain is usually not severe and many patients simply do not pay attention to it.
Swelling appears on the gums, bleeding and the development of gingivitis are possible.
Acute leukemia causes the appearance of hematomas on the body. Red and blue spots can appear on any part of the body and are one of the obvious characteristic symptoms that this disease causes.
If a person is often sick, has a weakened immune system and is highly susceptible to infections, the doctor may suspect acute myeloid leukemia.
With the development of leukemia, a person begins to lose weight sharply.
Changes in certain types of leukocytes lead to a decrease in immunity and a person becomes vulnerable to infectious diseases.

Symptoms of the chronic form

Chronic leukemia may not show any symptoms in the first months or even years of the disease. The body tries to heal itself by producing new granulocytes to replace the changed ones. But, as you know, cancer cells divide and degenerate much faster than healthy ones, and the disease gradually takes over the body. At first, the symptoms appear weakly, then become stronger and the person is forced to consult a doctor with unwellness.

Usually only after this is a diagnosis of chronic myeloid leukemia made.

Medicine distinguishes three stages of this disease:

Chronic myeloid leukemia begins gradually, with changes in several cells. Chronic myeloid leukemia and symptoms that are mild do not cause the patient to see a doctor. At this stage, the disease can only be detected using a blood test. The patient may complain of increased fatigue and a feeling of heaviness or even pain in the left hypochondrium (in the area of the spleen).
At the acceleration stage, the signs of leukemia are still weak. There is an increase in body temperature and fatigue. The number of altered and normal leukocytes is growing. A detailed blood test may reveal an increase in basophils, immature white blood cells, and promyelocytes.
The terminal stage is characterized by the manifestation of pronounced symptoms of chronic myeloblastic leukemia. The body temperature rises, in some cases up to 40 degrees, severe pain in the joints and a state of weakness appear. Upon examination, patients are found to have enlarged lymph nodes, an enlarged spleen, and lesions of the central nervous system.

Diagnostics

To diagnose acute myeloid leukemia, you must undergo a thorough examination at a medical facility and undergo tests. Various diagnostic procedures are used to detect leukemia. Diagnostics begins with questioning and inspection. People suffering from myeloid leukemia are characterized by enlarged lymph nodes, enlarged liver and spleen.

Based on the results of the examination, tests and diagnostic procedures are prescribed:

General blood analysis. As a result of the study, patients with leukemia have an increase in the number of immature white blood cells (granulocytes). The platelet count also changes.
Blood chemistry. Biochemistry reveals high amounts of vitamin B12, uric acid and some enzymes. However, the results of this type of study can only indirectly indicate myeloblastic leukemia.
Bone marrow biopsy. One of the most accurate studies in the diagnosis of leukemia. It is carried out after blood tests. As a result of puncture, a large number of immature leukocyte cells are also found in the bone marrow tissue.
Cytochemical analysis. The test is performed on blood and cat brain samples. Special chemical reagents, when in contact with biological samples from the patient, determine the degree of enzyme activity. In myeloblastic leukemia, the effect of alkaline photophosphase is reduced.
Ultrasonography. This diagnostic method allows you to confirm enlargement of the liver and spleen.
Genetic research. It is not carried out for diagnosis, but to make a prognosis for the patient. The nature of chromosomal disorders allows us to draw conclusions about future treatment methods and their effectiveness.

Prognosis and treatment

Acute myeloid leukemia very often leads to the death of the patient. Predictions can only be made after a complete examination of the patient and discussion of possible ways to treat the disease. Chemotherapy is used to treat acute myeloid leukemia. There is a specific treatment plan and principle of therapy, which is called induction.

During treatment, a complex of drugs is used, the administration of which is scheduled on a daily basis.

In the second phase of treatment, if the therapy has worked and remission has begun, drugs are selected to consolidate the result according to the individual characteristics of the patient. During the destruction of altered granulocytes with drugs. A certain amount of them remains and a relapse of the disease is possible. To reduce the likelihood of re-development of myeloblastic leukemia, complex therapy is carried out, including stem cell transplantation. Diagnosis of chronic myeloid leukemia and treatment should be carried out under strict medical supervision. All test results must be interpreted by physicians specializing in blood diseases.

Medicine offers the following treatment methods:

Chemotherapy.
Radiation therapy.
Bone marrow and stem cell transplant from a donor.
Extraction of altered leukocyte cells from the body using leukapheresis.
Splenectomy.

It is very difficult to cure the disease. Therapy is usually intended to alleviate the patient's condition and support his vital functions. However, with successful treatment, people suffering from chronic leukemia live for decades. Treatment takes a long time, but medical statistics know many cases of remission in patients with blood cancer.

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