Acute Myeloblastic Leukemia

Acute Myeloblastic Leukemia

Acute myeloblastic leukemia (AML) is a blood cancer that causes the bone marrow to be unable to produce mature myeloid white blood cells. This type of blood cancer is most common in people over the age of 65.

Myeloid is a type of white blood cell . Under normal conditions, this type of white blood cell plays a role in fighting infection and preventing damage to body tissues. In LMA, the bone marrow produces excessively immature myeloid so that the body is susceptible to infection.

This type of blood cancer is called acute because the cancer cells develop very quickly or are aggressive. Besides being known as acute myeloblastic leukemia , this type of blood cancer is also known as acute myeloid leukemia or acute myelogenous leukemia.

Causes of Acute Myeloblastic Leukemia

Acute myeloid leukemia or acute myeloid leukemia occurs due to DNA changes or mutations in the stem cells in the bone marrow. Stem cells themselves are cells that become the forerunners of blood cells.

DNA changes in stem cells cause disturbances in the function of the bone marrow in producing healthy blood cells. Instead, the bone marrow produces unhealthy and immature white blood cells called myeloblasts .

Myeloblasts develop rapidly, then replace healthy blood cells in the bone marrow. As a result, people with LMA are susceptible to various types of infections. This is because myeloblasts do not have the ability to fight infections in the body.

It is not known exactly what causes DNA mutations in stem cells in the bone marrow. However, there are factors that can increase a person's risk of suffering from acute myeloblastic leukemia, namely:

  • Age 65 or over
  • Male gender
  • Smoke
  • Frequent exposure to hazardous chemicals, such as benzene
  • Have a weak immune system, for example because you just had an organ transplant
  • Suffer from blood disorders, such as myelodysplastic syndromes and thrombocytosis
  • Suffering from genetic disorders, such as Down syndrome
  • Have a family history of ALM
  • Have had chemotherapy and radiotherapy before

Symptoms of Acute Myeloblastic Leukemia

Early stages of acute myeloblastic leukemia (AML) cause flu-like symptoms, such as:

  • Fever
  • Loss of appetite
  • Excessive sweating, especially at night
  • Easily tired
  • Headache

If the leukemia cells have spread to other parts of the body, the symptoms that can appear are:

  • Joint and bone pain
  • Blurred vision
  • Balance disorders
  • Easy bruising or a skin rash
  • Hard to breathe
  • pale skin
  • seizures
  • Nosebleed
  • Swollen or bleeding gums
  • Swollen lymph nodes in the neck, groin or armpits

When to see a doctor

As described above, the symptoms of early-stage acute myeloblastic leukemia can mimic flu-like symptoms. Therefore, do a doctor 's examination if you experience these complaints. Through examination, doctors can find out the cause accurately.

Diagnosis of acute myeloblastic leukemia

To diagnose acute myeloblastic leukemia, the doctor will conduct questions and answers regarding the symptoms and complaints experienced by the patient, the patient's medical history and family, and the lifestyle the patient lives.

After that, the doctor will do a physical examination to see if there is swelling in the lymph nodes.

Furthermore, to establish a diagnosis, the doctor can carry out further examinations, including:

  • Blood tests, including a complete blood count test , to check the number of red blood cells, white blood cells, platelets, peripheral blood smear, and hemoglobin in red blood cells
  • Bone marrow aspiration, to detect signs of cancer by taking a sample of bone marrow tissue
  • Lumbar puncture , to detect the spread of cancer cells by taking a sample of cerebrospinal fluid, which is the fluid around the brain and spinal cord
  • Scanning with X-rays, ultrasound, or CT scans , to detect infections or other disorders caused by acute myeloblastic leukemia in internal organs of the body
  • Genetic tests, to detect and examine changes that occur in chromosomes in cells, as well as determine treatment steps that can be taken

Unlike other types of cancer, the severity of acute myeloblastic leukemia (AML) is not divided by stage. However, doctors can determine the severity and treatment options based on several factors, namely:

  • Disease subtypes, such as acute promyelocytic leukemia
  • Age and overall health condition of the patient
  • Results of follow-up examinations

Treatment of Acute Myeloblastic Leukemia

To treat acute myeloblastic leukemia, the doctor will perform the type of action according to the results of the patient's examination. In general, LMA treatment is divided into two stages, namely:

Stage 1 – remission induction therapy

At this stage, the doctor will give chemotherapy to kill as many cancer cells in the blood and bone marrow as possible. This stage generally lasts 3–4 weeks, depending on the patient's condition and the severity of the cancer.

However, chemotherapy usually cannot eliminate all cancer cells. Therefore, further treatment needs to be done to prevent cancer cells from reappearing.

Stage 2 – consolidation or post-remission therapy

This stage aims to destroy the remaining cancer cells or left behind during the first stage. Therapy that can be done at this stage include:

  • Advanced
    chemotherapy Advanced chemotherapy is performed if chemotherapy in the first stage has been able to eliminate most of the cancer cells. This chemotherapy aims to kill remaining cancer cells and prevent recurrence.
  • Bone marrow transplant
    This procedure is performed by introducing healthy blood stem cells into the body. The goal is for the bone marrow to re-produce healthy blood cells. Healthy blood stem cells can come from the patient himself ( autologous ) or donated from another person ( allogeneic ).
  • Target
    therapy Target therapy is the administration of drugs to stop the growth and spread of cancer cells. This therapy can be combined with chemotherapy.

Acute myeloblastic leukemia complications

If left untreated, patients with acute myoblastic leukemia (AML) can experience several complications, namely:

Immune system disorders

Acute myeloblastic leukemia can make sufferers susceptible to infection. In fact, infections in people with LMA can be more serious than infections in normal people.

Bleeding

Acute myeloblastic leukemia makes the body more susceptible to bruising and bleeding due to thrombocytopenia . Bleeding can be worse than usual, and can occur in the stomach, lungs, and brain.

Leukostasis

Leukostasis occurs when the number of white blood cells in the bloodstream is very high (>50,000/µL of blood). This condition can trigger the clumping of white blood cells, which can clog blood vessels and interfere with oxygen intake to the body's cells, especially in the brain and lungs.

Apart from complications from AML itself, complications can also arise due to side effects of treatment. Patients who have undergone high-dose chemotherapy are prone to experience infertility or infertility. This condition can be temporary or permanent.

Prevention of acute myeloblastic leukemia

Given that the cause is not known with certainty, acute myeloblastic leukemia is difficult to prevent. However, there are several steps that can be taken to reduce the risk of this condition occurring, namely:

  • Quit smoking
  • Avoid exposure to hazardous chemicals, such as benzene, formaldehyde, and pesticides
  • Use personal protective equipment ( PPE ) to limit exposure, if you work in an environment that is prone to chemical exposure
  • Eat a healthy and nutritionally balanced diet
  • Maintain body weight to remain ideal
  • Exercise regularly
  • Manage stress well
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