Medicines for Acute myeloid leukaemia

What it is

Acute myeloid leukaemia (AML) is a type of blood cancer that develops quickly and affects the myeloid cells — a group of blood cells made in the bone marrow that would normally develop into certain white blood cells, red blood cells, and platelets. In AML, immature abnormal cells multiply rapidly in the bone marrow, crowding out normal blood cells. AML can affect people of any age but becomes more common with increasing age, and is the most common acute leukaemia in adults. Because the abnormal cells crowd out healthy blood cells, the symptoms often reflect a shortage of normal blood cells, and can include: looking pale and feeling tired or breathless (from anaemia); frequent or persistent infections (from a lack of healthy white cells); easy bruising or bleeding, such as nosebleeds or bleeding gums (from a lack of platelets); and other symptoms such as a high temperature, night sweats, weight loss, and feeling generally unwell. Because these symptoms are common and usually caused by other, less serious conditions, they usually do not indicate leukaemia — but because AML develops quickly and needs prompt treatment, persistent, unexplained, or worrying symptoms should be checked, and a blood test can quickly point towards a diagnosis. AML is treated by specialist teams and treatment is intensive, usually based around chemotherapy, with other treatments (including targeted therapies for certain types, and sometimes a stem cell transplant) in some cases. Outcomes vary and depend on factors such as the person’s age and health and the specific features of the leukaemia. The key messages are awareness of the symptoms and prompt assessment, so treatment can start quickly.

How it is treated

Acute myeloid leukaemia is diagnosed and treated by specialist haematology teams, and because it develops quickly, treatment usually begins promptly. Diagnosis involves blood tests and examination of the bone marrow, with specialised tests on the cells that confirm the type of AML and its specific genetic and other features — these are important, as they guide treatment and give information about the likely outlook. Treatment is intensive and usually based around chemotherapy, given in phases to bring the leukaemia into remission and then to consolidate it; the specific approach depends on the type of AML and the person’s age and general health. Other treatments may include targeted therapies (which act on specific features of certain types of AML), and, for some people, a stem cell (bone marrow) transplant. For those who are less able to tolerate intensive treatment (for example some older or less fit patients), gentler treatment approaches aimed at controlling the leukaemia and maintaining quality of life may be used. Supportive care is a vital part of treatment — including preventing and treating infections and supporting the blood counts with transfusions where needed. Treatment is demanding, and recovery and follow-up take time. Outcomes vary considerably depending on factors such as the person’s age and fitness and the genetic features of the leukaemia, and treatments continue to improve. Because AML develops quickly, the key messages are awareness and prompt assessment: symptoms such as persistent tiredness and paleness, frequent infections, easy bruising or bleeding, unexplained fevers, night sweats, or weight loss should be checked — a blood test can quickly point towards the diagnosis and allow treatment to begin. As with other blood cancers, these symptoms are far more often due to common causes than to leukaemia, but persistent or unexplained symptoms should not be ignored.