Doctor explains Acute Myeloid Leukaemia (AML) | Causes, symptoms, treatment & more

In this video, I delve into a critical topic that affects many lives: acute myeloid leukaemia (AML). As a doctor, I understand how overwhelming it can be to navigate the complexities of such a serious condition. My goal is to break down this information into digestible segments, making it easier for you and your loved ones to understand what AML is, its symptoms, causes, diagnosis, treatment options, and prognosis.

Acute myeloid leukaemia is a fast-growing cancer that originates in the bone marrow, the soft tissue inside your bones responsible for producing blood cells. In a healthy individual, the bone marrow functions like a well-oiled machine, generating three types of blood cells: red blood cells that transport oxygen, white blood cells that combat infections, and platelets that help with blood clotting. However, in AML, this process goes awry. The bone marrow begins to produce an excess of immature white blood cells known as myeloid blasts. These cells fail to mature properly, multiply uncontrollably, and ultimately crowd out healthy blood cells, leading to severe health issues such as anemia, increased susceptibility to infections, and bleeding problems.

Recognizing the symptoms of AML is crucial for early diagnosis. The onset of AML is typically rapid, often developing over a few weeks. Common symptoms include persistent fatigue, shortness of breath even during light activities, pale skin, frequent infections, easy bruising or bleeding, fever, night sweats, unexplained weight loss, and sometimes bone pain. These symptoms can be vague and may resemble other health conditions, which is why it’s essential to consult a healthcare professional if they persist.

The exact cause of AML is not always clear, but it often begins with genetic mutations that affect blood cell growth. These mutations can occur randomly or be inherited. Certain risk factors can increase the likelihood of developing AML, including age (being over 60), smoking, previous chemotherapy or radiation therapy, long-term exposure to chemicals like benzene, and pre-existing bone marrow diseases. Genetic conditions such as Down syndrome can also elevate risk. However, it’s important to remember that having one or more risk factors does not guarantee that someone will develop AML.

When it comes to diagnosing AML, the process typically starts with a blood test to evaluate the levels of red blood cells, white blood cells, and platelets. If abnormalities are detected, a referral to a specialist, usually a hematologist, is made. A definitive diagnosis often requires a bone marrow biopsy, where a small sample of bone marrow is extracted and examined under a microscope. Additional tests, such as genetic testing and flow cytometry, may be conducted to identify specific mutations and determine the most effective treatment plan.

Treatment for AML must begin promptly due to the aggressive nature of the disease. The primary approach is chemotherapy, which involves powerful drugs designed to kill cancer cells. This treatment is generally administered in three phases: induction therapy aims to eliminate as many leukemia cells as possible; consolidation therapy targets any remaining cells to prevent recurrence; and maintenance therapy involves lower doses over time to keep the cancer in remission. For some patients, targeted therapy may be an option, utilizing newer drugs that block specific genetic mutations in the cancer cells.

In certain cases, a stem cell transplant may be recommended, which is currently the only known cure for AML. This procedure involves intensive chemotherapy or radiation to eradicate the cancer, followed by the infusion of healthy stem cells to restore the bone marrow. While effective, it’s important to note that stem cell transplants carry significant risks and are not suitable for everyone.

As with any cancer treatment, side effects are a reality. Chemotherapy can lead to nausea, vomiting, hair loss, fatigue, and an increased risk of infections or bleeding due to low platelet counts. Stem cell transplants are more complex and can result in serious complications, including infections and graft-versus-host disease, where the new immune cells attack the body. Your healthcare team will closely monitor your condition and may suggest palliative care to help manage symptoms and side effects.

The prognosis for AML varies significantly based on several factors, including age, the specific type of AML, and overall health. While some individuals achieve complete remission, where no cancer cells are detectable and blood counts return to normal, there is a risk of relapse. Survival rates are improving with advancements in treatment, but AML remains a serious condition requiring expert care. For children, the five-year survival rate is approximately 67%, while for adults under 60, it ranges from 40% to 60%. In adults over 60, the survival rate drops to around 15% to 30%.

If you or someone you know has been diagnosed with AML, it’s essential to stay informed and seek support. Early diagnosis and expert care can significantly impact outcomes. Remember, this video and blog are intended as educational resources and should not replace personal medical advice. Always consult your healthcare provider for any health concerns.

For more information and resources on AML, please check the description box of the video. Thank you for taking the time to learn about this important topic, and I hope you find the information helpful for you and your loved ones.