Understanding Acute Myeloid Leukemia
- High school teacher and mother of two Callie Zenner is sharing her journey from an aggressive leukemia diagnosis to remission, returning to the classroom, and navigating the emotional challenges of survivorship. She was diagnosed with acute promyelocytic leukemia (APL) is an aggressive type of acute myeloid leukemia (AML), after experiencing fatigue and bruising.
- 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. 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 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.
Zenner received the diagnosis in a phone call from her doctor less than 48 hours after her bloodwork was completed, allowing her to quickly begin planning her treatment, she told Idaho ED [IDED] News.
Read More“It’s a very aggressive form of acute leukemia,” Zenner explained to IDED News in a recent interview.
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Luckily, her cancer had been discovered at an early stage and she had her family by her side for support.
She remembers her husband telling her, “You’ve got this. You absolutely crush everything you set your mind to. You’re going to kick leukemia’s a**.”
Zenner, who recalled it being “heartbreaking” to take a break from teaching to fight the disease, underwent five weeks of intensive treatment in Seattle before returning home to continue chemotherapy five days a week for eight months.
By February 2025, her scans showed no evidence of disease, though she continued monitoring and recovery. After taking time to rest during the spring, she felt ready to return to the classroom for the 2025-2026 school year.
One of her students told IDEH News that Zenner’s strength through her leukemia battle has taught her that “you can go through hard things and come out bette,” adding, “She showed me what resilience means.”
Zenner further reflected on the intensity of her leukemia treatment, in an Instagram post in the summer of 2025, sharing that her treatment also included two bone marrow biopsies, numerous transfusions, hospital stays, emergency room visits, and more than 280 chemotherapy doses over the first eight months.
Last month, Zenner shared additional insight into her survivorship journey, writing alongside a back-and-white photo of St. Joseph’s Regional Medical Center in Lewiston, Idaho, “I had my 15-month cancer screening, even though this is my 5th screening I’m only recently realizing how hard it is to navigate this phase.
“I’m not sharing this for sympathy or pity, but rather as a gentle reminder of something we all forget: just because someone appears completely fine on the outside that doesn’t mean they aren’t carrying a heavy weight. For me, remission is a beautiful traumatic gift.”
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She continued, “From the outside, ‘remission’ looks like a finish line where you’re suddenly fine and the battle is over. But the reality is that the trauma doesn’t just vanish. I still freeze when I see a new bruise, and waiting a week for screening results brings back all the old terror. I am incredibly joyful and grateful to be here, but I’m not ‘all better’—I am still actively carrying the weight of what I went through. I’m working hard to power through and appear normal and ‘fine.’
“I am allowed to be happy to be alive and completely sick of this at the same time. Remission isn’t a clean break; it’s a landscape where a simple bruise can make my heart drop. I hate the waiting. I hate the uncertainty. I am glad I am here, but I am allowed to admit that keeping up this strength is exhausting. I’m giving myself permission to not be ‘perfectly strong’ this week.”
Aside from navigating life in remission, Zenner also expressed how joyful she feels that her hair is finally growing back.
“If you’re a woman that’s been on a cancer journey you understand this milestone! This is the first time I haven’t worn a scarf, wig or extensions since July 2024! This journey isn’t the same for everyone,” she wrote alongside a video compilation of her hair growth, shared on her Instagram page in May.
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“Some people are not affected by the hair loss. For others, like myself, it’s really losing a large part of yourself,” she added.
Zenner then applauded her hairstylist as her “queen” that’s “been there through it all and understands fully” how much her hair means to her.
Coping With Hair Loss
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. 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. Zenner did not mention having a stem-cell transplant, but it’s important to understand this form of treatment may be helpful for other patients.
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.”
What You Need to Know About Survivorship
Whether you’re beginning your journey into survivorship or are a seasoned survivor, you’ll quickly learn that it’s a term with many layers. At its simplest, ‘survivorship’ signifies the state of living beyond a challenging event or diagnosis, such as cancer. More specifically, it marks the period after treatment where a patient goes from merely surviving to thriving, as they navigate their newfound lease on life.
It’s important to remember that survivorship isn’t just an end state – it’s a continuous journey. It begins the moment a person is diagnosed with a significant health condition and continues throughout their life. You might hear people say things like, “from the moment of diagnosis, you become a survivor.”
It’s a powerful sentiment that reflects the courage and resilience involved in battling a serious illness.
Being a survivor also means redefining your life while coping with the aftermath of disease and its treatment. This phase might include the challenge of dealing with physical and emotional changes, attending regular check-ups, the fear of recurrence, or the need for long-term medication. Despite these hurdles, many survivors find unique strength, growth, and transformation during this time.
Survivorship is much more than just the absence of disease—it’s a new stage of life, a rite of passage. Your journey might not have been one you would have chosen, but through it, you’ll uncover a greater understanding of yourself and what you’re capable of. Each person’s survivorship journey is unique, and how you choose to travel is entirely up to you.
Remember—navigating this new terrain called ‘Survivorship’. It might be challenging, but remember, you’re not alone. There are ample resources and support systems designed to help you along the way.
Continued Medical Care
Don’t lose sight of the importance of continued medical care – always keep your follow-up appointments and adhere to any healthcare recommendations.
Remember, embracing these coping strategies can help you navigate your way into survivorship with greater ease and renewed energy. Just remember – slow and steady wins the race! You’ve overcome huge hurdles, it’s okay to take this new stage of your life at your own pace.
Resilient: Learning To Overcome Any Obstacle
Additionally, health checkups are an integral part of maintaining wellness and spotting potential health issues early. This holds true for everyone, but even more so for a person who’s in the throes of survivorship.
One of the main reasons you’ll want to maintain routine health checks is to monitor for recurrence. While the hope is always for complete recovery, there’s a possibility of the disease returning—even with successful treatment. Regular checkups allow you to keep a vigilant eye on the situation, leading to early detection and treatment if any problem emerges.
Contributing: SurvivorNet Staff
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