Acute Myelogenous Leukemia

Acute myelogenous leukemia (AML), also called acute myeloid leukemia, is an aggressive cancer of the blood and bone marrow. Abnormal immature myeloid cells build up in the bone marrow and interfere with the production of healthy red blood cells, platelets and white blood cells. AML is more common in adults, but it can occur at any age. Because it can progress quickly, aml leukemia usually requires prompt medical evaluation and treatment.

Acute myeloid leukemia symptoms can resemble common illnesses and may appear or worsen over a short time. They develop when AML reduces the number of healthy red blood cells, platelets and infection-fighting white blood cells. Symptoms can vary from person to person, and having them does not by itself confirm acute leukemia.

AML develops when DNA changes cause immature myeloid blood-forming cells to grow abnormally and fail to mature into healthy blood cells. These changes may disrupt normal cell growth and allow abnormal cells to accumulate in the bone marrow. In many people, no single cause can be identified, so knowing what causes leukemia is not always possible for an individual.

Evaluation commonly includes a complete blood count, a peripheral blood smear, and bone marrow aspiration and biopsy. Doctors may also use flow cytometry to study cell-surface markers, chromosome testing to identify genetic changes, and molecular testing for gene mutations. Together, these results help confirm acute myeloid leukemia and guide treatment.

Treatment of acute myelogenous leukemia (AML) depends on the patient’s age, overall health, genetic abnormalities, and disease risk. The main goal is to achieve remission and prevent relapse.

• Chemotherapy: Intensive induction chemotherapy, commonly using a cytarabine-based regimen combined with an anthracycline, is often used for fit patients.
• Targeted therapy: Drugs targeting specific genetic changes may be used. For example, FLT3 inhibitors can be used in FLT3-mutated AML, while IDH inhibitors may be used in patients with IDH1 or IDH2 mutations.
• Lower-intensity therapy: Older adults or patients who cannot tolerate intensive chemotherapy may receive less-intensive treatment, commonly a hypomethylating agent such as azacitidine or decitabine combined with venetoclax.
• Allogeneic stem cell transplantation: For patients with a high risk of relapse or certain high-risk disease features, an allogeneic hematopoietic stem cell transplant may be considered after remission is achieved.
• Supportive care: Blood and platelet transfusions, antibiotics or antifungal medications, and management of treatment-related complications are important throughout therapy.
• Relapsed or refractory AML: Additional chemotherapy, targeted therapies, clinical trials, or stem cell transplantation may be considered depending on the patient’s disease characteristics and previous treatment.

Overall, AML treatment is individualized according to molecular findings, disease risk, response to therapy, and the patient’s general condition.

Acute myelogenous leukemia can sometimes be cured, but it is a serious disease that requires prompt treatment. Remission means that tests show no detectable evidence of active AML, although monitoring remains important. Relapse means the leukemia returns after a period of remission, while measurable residual disease refers to leukemia cells that remain detectable with sensitive testing and may affect treatment planning.

Follow-up after leukemia treatment is individualized and may include regular visits, blood counts and bone marrow testing when indicated. Molecular testing or measurable residual disease testing may help monitor remission and detect changes early. Your care team can adjust the follow-up plan based on your treatment, response and ongoing health needs.