Acute Myeloid Leukaemia

Acute Myeloid Leukaemia (AML) is a fast-growing cancer produced by high numbers of abnormal white blood cells, called myeloblasts. These cells are immature white blood cells, and when they overproduce in the bone marrow, they crowd out healthy white blood cells, red blood cells and platelets. They can also spill out and spread to other parts of the body.

There are several subtypes of Acute Myeloid Leukaemia, named according to the type of blood cell affected. Depending on the subtype, symptoms and treatment options may vary. For example, some types of Acute Myeloid Leukaemia can cause discomfort and swelling in parts of the body such as the gums, while other subtypes are associated with abnormalities in blood clotting.

There are a number of known risk factors for developing childhood Acute Myeloid Leukaemia. These include having a brother or sister (especially a twin) with leukaemia, exposure to cigarette smoke or alcohol before birth and having certain genetic disorders.

Past treatment with chemotherapy or high doses of radiation are also risk factors. It is also possible that exposure to industrial chemicals like benzene may contribute to the development of Acute Myeloid Leukaemia. Cancer researchers are also investigating possible genetic influences, such as damaged genes that control blood cell development.

The symptoms of Acute Myeloid Leukaemia are caused by a lack of normal blood cells, and may include:

• bruising and bleeding
• frequent infections
• paleness
• fatigue
• dizziness
• fever
• bone pain

Acute Myeloid Leukaemia is diagnosed with tests that examine the blood and bone marrow, and may include the following:

• a physical examination and history check
• a full blood count (a test measuring the number and status of different types of blood cells)
• a bone marrow aspirate (a biopsy that removes cells from the hip bone for microscopic
examination)

A lumbar puncture may also be done. This involves using a needle to take a small volume of spinal fluid to examine in the laboratory.

Once Acute Myeloid Leukaemia has been diagnosed in the child, tests may be conducted to determine the growth or spread of the cancer to other parts of the body.

The main form of treatment for Acute Myeloid Leukaemia is chemotherapy (anti-cancer drugs), with drug combinations personalised as much as possible to suit each individual case. The way the chemotherapy is given depends on the type of cancer being treated. Radiation therapy, stem cell transplants, and other drug therapy may also be necessary in some cases.

The aim of initial treatment (induction therapy) is to achieve remission, where there is no evidence of leukaemia cells remaining in the body and blood cell levels have returned to normal. Once remission has been achieved, more treatment (maintenance therapy) is given to reduce the risk of relapse.

During treatment, children with Acute Myeloid Leukaemia are likely to need antibiotics and other drugs to treat or prevent infection. Blood or platelet transfusions may also be required to restore normal blood counts.

Regular follow-up after treatment may involve physical examinations, as well as some of the same tests used to diagnose the cancer initially. Follow-up is needed not only to check for any possible signs of the cancer returning, but also to check for and manage any long-term side effects of treatment.