Understanding Acute Myeloid Leukemia
- Shelley Garvey, a 46-year-old Australian mom, thought her persistent headaches and tiredness were from a cold—but it turned out to be rare acute myeloid leukemia (AML).
- Garvey underwent intensive chemotherapy for 11 months and a stem cell transplant. She’s been in remission for more than five years.
- Acute myeloid leukemia, also known as AML, is a cancer that affects bone marrow the spongy tissue inside of your bones. It is a rare cancer overall, but it is the most common type of leukemia in adults, like Garvey. Children rarely get AML.
- AML is diagnosed by extracting samples of liquid bone marrow and a chip of bone from the back of the hip. The samples are then tested to determine if blood cells in the bone marrow are abnormal.
- Stem-cell transplants, which Garvey underwent, can be effective in the treatment of blood cancers such as AML. Not all people with AML are candidates for stem-cell transplants. Doctors evaluate each person’s individual risk potential to determine who is a candidate for one.
Garvey, who was diagnosed with AML six years ago and has since undergone a life-saving stem cell transplant, had endured an approximate-seven weeks of a dull headache and pulsating feeling behind her head before seeking medical advice.
Read More
Garvey, who underwent treatment for 11 months, admitted she felt incredible determined to beat the disease for her children.
“I had this attitude that I’m going to do this. I’m going to get through this,” Garvey, who had her husband as her caregiver during that arduous time, told 7News.
Thankfully, intensive chemotherapy and a stem cell transplant led her to remission.
Garvey, who has been in remission for more than five years, praises her stem cell donor for “ultimately” allowing her to live
She also remains overwhelmingly grateful for the Leukaemia Foundation, saying they “were our saving grace, providing my husband and I with accommodation. They gave us a home away from home.”
Garvey added, “What they gave us was community, at a time when we felt so alone. My family and I learned that we are more resilient than we know.
“The Leukaemia Foundation relies on donations so that it can continue to provide accommodation to families that need to relocate for treatment.”
Understanding Acute Myeloid Leukemia
Acute myeloid leukemia, also known as AML, is a cancer that affects bone marrow the spongy tissue inside of your bones. It is a rare cancer overall, but it is the most common type of leukemia in adults, like Garvey. Children rarely get AML.
“To understand acute myeloid leukemia, you have to understand how the bone marrow works,” Dr. Mikkael Sekeres, former director of the Leukemia Program at Cleveland Clinic Cancer Center and current chief of the Division of Hematology at University of Miami Health System, previously told SurvivorNet.
“The bone marrow is the factory that makes all of the cells that wind up in our blood stream.”
What is Acute Myeloid Leukemia (AML)?
This so-called factory makes red blood cells that bring oxygen to our tissues, white blood cells that make up the immune system, as well as platelets, which help stop bleeding, Dr. Sekeres explained.
All of these cells perform essential functions in the body, and a spike or decline in any of them can lead to some serious health issues.
“When a person has cancer of the bone marrow, such as acute myeloid leukemia or myelodysplastic syndromes, that factory gets broken. These are cancers,” he said. “Cancers grow, and they grow in an uncontrollable way.”
Dr. Sekeres pointed out that the way blood cancer grows is different from the way other, solid-tumor cancers grow. With breast cancer, for example, someone may develop a lump or a tumor that grows overtime. With AML, as cancer grows in a confined space (the bone marrow), the normal cells in this space that would be making the red blood cells, white blood cells and platelets, begin dying off. This leads to the bone marrow being filled with cancer cells.
How to Recognize Symptoms of Acute Myeloid Leukemia
Treating Acute Myeloid Leukemia (AML)
Acute myeloid leukemia is a fast-growing blood cancer that begins in the bone marrow, the factory that makes white and red blood cells and platelets. Within the bone marrow are stem cells that eventually develop into white blood cells (WBCs), red blood cells (RBCs), and platelets, which help blood clot.
Stem cells can copy themselves to make progenitor cells or precursor cells. Myeloid progenitor cells turn into red blood cells, granulocytes (a type of white blood cell), and platelets. AML affects the myeloid progenitor cells during a stage of development when they are called myeloblasts.
With AML, myeloblasts fail to turn into fully developed blood cells, leaving them to build up in the bone marrow and blood.
AML is diagnosed by extracting samples of liquid bone marrow and a chip of bone from the back of the hip. The samples are then tested to determine if blood cells in the bone marrow are abnormal.
WATCH: An AML Diagnosis What are the Next Steps?
Dr. Gail Roboz, an AML expert and medical oncologist at Weill Cornell Medicine, explained to SurvivorNet in an earlier interview, “The majority of patients have this sporadically out of the clear blue sky.”
Symptoms for acute myeloid leukemia can include:
- Flu-like symptoms
- Fatigue
- Fever
- Loss of appetite
AML causes certain symptoms, but having these symptoms doesn’t necessarily mean you have AML. Your doctor will do diagnostic tests to confirm whether or not you have AML before recommending a treatment.
Your doctor will then perform tests to diagnose you, and those tests include:
- Blood tests. In people with AML, white blood cell counts may be high, and red blood cell and platelet counts may be low. These tests can also show immature cells in the blood that should only be found in the bone marrow.
- Bone marrow biopsy. Removing and testing a bone marrow sample helps confirm AML after an abnormal blood test result.
- Lumbar puncture. This test uses a sample of spinal fluid to diagnose AML.
- Molecular and genetic testing. Your doctor can do tests to determine whether you have certain genes related to AML and if your cancer might respond to specialized treatments.
WATCH: Treatment decisions for AML
For people deemed healthy enough, induction therapy is the standard treatment for AML. The process involves a seven-day chemotherapy regimen, followed by several weeks of recovery. The goal of this high dose of chemo is to induce remission.
A stem cell transplant is another option for treating AML. After a high dose of chemotherapy, a stem cell transplant gives the patient healthy cells to replace the ones that chemotherapy may have killed.
After chemo and a transplant, the recovery process can be difficult because the immune system will be compromised. Finding a genetic match in a donor may also be difficult.
Why a Stem-Cell Transplant?
A stem-cell transplant doesn’t directly fight cancer cells, rather it helps your body create healthy cells after chemotherapy and other treatments have destroyed them.
The first course of treatment for AML patients is generally a combination of two chemotherapy drugs, known as “induction chemotherapy.” Its goal is to kill cancer cells, but along with killing cancer cells, chemotherapy also kills the body’s healthy cells and platelets. A stem-cell transplant is designed to help rebuild those blood cells and platelets and restore the immune system. The healthy new cells may also help prohibit recurrence of the disease.
“We don’t believe that chemotherapy, for the majority of leukemias, is sufficient in order to cure patients of their disease, forever,” Dr. Caitlin Costello, hematologist-oncologist at UC San Diego Health, told SurvivorNet in an earlier interview.
“And so a transplant is an opportunity to do that cure patients with leukemia.”
Dr. Caitlin Costello breaks down the basics about stem-cell transplants for SurvivorNet
Which AML Patients are Candidates for Stem-Cell Transplants?
Not all AML patients are candidates for a stem-cell transplant. Some need only chemotherapy, and some high-risk patients may not be able to tolerate a transplant. It all comes down to your medical team determining your risk group.
Dr. Raoul Tibes, director of the Clinical Leukemia Program at NYU Langone Health, told SurvivorNet in an earlier interview that AMLs are grouped according to what are called cytogenetics (loss or changes to the structure of chromosomes) and other molecular markers. Doctors also look for genetic mutations on top of chromosomes, which could be indicators of risk.
Dr. Raoul Tibes discusses how an individual’s AML risk group is determined with SurvivorNet.
“Based on all that information, we can group leukemias into the chromosome status, as well as mutations and genes. We take them together and then we have three or four different risk stratification groups,” he says. “That helps us decide which therapy we use.”
Contributing: SurvivorNet Staff
Learn more about SurvivorNet's rigorous medical review process.
ANSWER QUESTIONS
