Acute myeloid leukemia

Acute myeloid leukemia (AML), also known as acute myelogenous leukemia, is a cancer / myeloid cancer dosglóbulos white line that is characterized by rapid proliferation of abnormal cells and malignant - blasts - which is not mature, and do not perform its function even if accumulate in the bone marrow, interfering with the normal production of other blood cells. It is the most common type of acute leukemia affecting adults, and its incidence increases with age. Although AML is a relatively rare disease, accounting for about 1.2% of deaths caused by malignancies in the United States, is expected to increase in incidence due to the aging population.

The symptoms are caused by the replacement of normal bone marrow cells, resulting in a decrease in red blood cell count, platelets and normal leukocytes. These symptoms include fatigue, shortness of breath, bleeding and increased risk of infections. Although several risk factors for AML are known, the specific cause remains uncertain. A feature of the disease is a rapidly progressive, which can be fatal within a short period of time (weeks or months) if left untreated.

Acute myeloid leukemia is a potentially curable disease, but only a small proportion of patients are cured with therapy currently used. Usually the treatment begins with chemotherapy aimed at inducing remission, although the majority of patients requiring a bone marrow transplant to reach a cure.

It is also called acute nonlymphocytic leukemia (in English acute nonlymphocytic l, abbreviated as ANLL).

Signs and Symptoms

Most of the signs and symptoms of AML are due to an increased number of white blood cells or malignant displacing interfering in any way with the normal production of blood cells in bone marrow. The lack of normal white blood cells renders the patient susceptible to infections. Have a lack of red blood cells (anemia) can cause fatigue, shortness of breath and pallor. The lack of platelets can lead to the occurrence of major bleeding or bruising to the minimum trauma.

The first symptoms of AML are most often nonspecific and may be similar to the flu or other common diseases. Some possible generalized symptoms include fever, fatigue, weight loss or loss of appetite, shortness of breath, anemia, bruising, bleeding, petechiae, bone pain, joint pain and frequent infections and / or persistent. Splenomegaly may occur, but is usually transient and asymptomatic. Lymphadenopathy is rare in AML, in contrast with acute lymphoblastic leukemia.

Some patients may experience swelling of the gum due to infiltration of leukocytes into the tissue. In some rare cases, the first sign of the disease is the development of a tumor outside of the bone marrow granulocytic sarcoma call or chloroma. Often the patient may have no symptoms, as well as leukemia can be detected during routine blood tests.

Diagnosis

The first clue, important for the diagnosis of AML is typically an abnormal result on a complete blood count. Already definitive diagnosis often requires a biopsy of the bone marrow aspiration. The bone marrow examination is often performed in order to identify the type of abnormal blood cells. However, if there are many white blood cells in the blood circulation, the bone marrow biopsy may not be required. Bone marrow or blood is analyzed using optical microscopy, flow cytometry as well as for diagnosing the presence of leukemia and differentiate among its subtypes.

The diagnosis and classification of AML can be complex and must be performed by a physician experienced in the field of hematology and pathology. In simple cases, the presence of certain morphological characteristics (such as Auer rods) or specific results of flow cytometric can distinguish this from other types of leukemias. However, in the absence of such features, the diagnosis may be more difficult.

According to the criteria adopted by the World Health Organization, the diagnosis of AML is established by demonstrating the involvement of more than 20% of the blood and / or bone marrow myeloblasts. The disease must be carefully differentiated terms "pre-leukemic" as myelodysplastic or myeloproliferative syndromes, which are treated differently.

Due to better prognosis (and greater ease of treatment) of acute promyelocytic leukemia (APL), it is important to quickly establish a definitive diagnosis. The method of fluorescence in situ hybridization is often used for this purpose, easily identifying chromosomal translocation that characterizes APL.