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Monday, June 22, 2009

Acute Myelogenous Leukemia

Monday, June 22, 2009
Acute myelogenous leukemia (AML} results from damage to the DNA of a single myeloid stem cell in the bone marrow. This cell then produces other abnormal cells called leukemic blasts, and in time these leukemia cells crowd out the production of healthy red blood cells, platelets, and white cells.

Who Gets AML:

AML is most common in people older than 50, but AML does account for 15% of diagnosed acute childhood leukemia cases, making it one of the most common types of leukemia.

How AML is Treated:

Because AML progresses quickly, treatment is generally initiated very quickly after diagnosis. Very intense chemotherapy is the first treatment of choice for most patients. Because of the intensity of the chemotherapy required, AML patients are usually admitted to the hospital for their first cycle of chemotherapy, called induction therapy. The goal of induction therapy is to eliminate any signs of leukemic blast cells in the blood and bone marrow. After AML patients have achieved remission, they will require hospitalization for maintenance chemotherapy at regular intervals to rid the body of any remaining leukemic cells.

Another important option for patients in remission is bone marrow transplantation. An autologous stem cell transplantation involves wiping out the patient's bone marrow with very intense chemotherapy and then infusing the patient with his or her own stem cells, harvested after remission was achieved and frozen for later use. An allogeneic stem cell transplantation involves the harvesting of healthy stem cells from a matched donor. The patient's bone marrow is obliterated through intense chemotherapy and the donor cells are infused. A graft-versus-leukemia effect occurs in which the healthy donor marrow recognizes and wipes out all remaining leukemic cells. A less intense option with more gradual beneficial effects is the "mini" tranplant which uses a less intense regimen of conditioning with radiation and chemotherapy; the process of the donor marrow taking over happens more gradually due to the lighter conditioning, over two to four weeks from the time of transplant.