What is acute myeloid leukemia?

Acute myeloid leukemia (AML) is also called acute myelogenous leukemia. It's a type of leukemia that causes the body to make too many myeloblasts.

Myeloblasts are a type of young white blood cell. They usually become mature, infection-fighting cells. But if those young cells don't mature like they should, they can start to grow abnormally and out of control. Then they can crowd out normal blood-making cells and cause swollen glands or other lumps.

Symptoms of AML include weakness and fatigue, fever, and night sweats. You may also bruise or bleed easily or have pain or a feeling of fullness below the ribs. Or you may have pinpoint spots under the skin from bleeding.

Your doctor will ask you about any current symptoms, your medical history, and your family history. You'll have a physical exam, where your doctor will check your lymph nodes, liver, and spleen.

You'll have tests, which may include:

• Lab tests, including a complete blood count.
• Imaging tests, such as a CT scan, an MRI, or an X-ray.
• A lumbar puncture to find out if leukemia cells are in the fluid in your spine.
• Tissue tests, such as a bone marrow aspiration and biopsy.
• Genetic tests that look for changes in your genes and chromosomes.
• Heart tests to check how well your heart works, such as an echocardiogram.

If the exam and test results point to leukemia, the doctor may do more tests on the blood or bone marrow samples to learn more about the type or subtype of leukemia it is.

The main treatment for AML is usually chemotherapy. Treatment might also include a stem cell transplant and other medicines, including targeted therapy. A clinical trial may be a good choice.

Treatments are often given in two steps:

• The first step is induction therapy with intensive chemotherapy. It may also include targeted therapy and immunotherapy. This step ends once your child is in remission and there are no more signs of leukemia cells.
• The second step is post-remission therapy. It usually involves more chemotherapy and a stem cell transplant. It's done to treat any remaining leukemia cells that may be in the body but don't show up in tests.

Your child may also have preventive treatment to the brain and spinal cord with chemotherapy.

Treatments for childhood leukemia have improved over time. But treatment can take a while. Sometimes it can take more than 6 months to complete.

• Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
• Follow your doctor's instructions to relieve pain. Pain from cancer and surgery can almost always be controlled. Use pain medicine when you first notice pain, before it becomes severe.
• Eat healthy food. If you do not feel like eating, try to eat food that has protein and extra calories to keep up your strength and prevent weight loss.
• Get some physical activity every day, but do not get too tired.
• Get enough sleep, and take time to do things you enjoy. This can help reduce stress.
• Think about joining a support group. Or discuss your concerns with your doctor or a counselor.
• If you are vomiting or have diarrhea:
  • Drink plenty of fluids to prevent dehydration. Choose water and other clear liquids. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
  • When you are able to eat, try clear soups, mild foods, and liquids until all symptoms are gone for 12 to 48 hours. Other good choices include dry toast, crackers, cooked cereal, and gelatin dessert, such as Jell-O.
• If you have not already done so, prepare a list of advance directives. Advance directives are instructions to your doctor and family members about what kind of care you want if you become unable to speak or express yourself.