Leukemia

Acute Myeloid Leukemia

Signs and Symptoms
Diagnosis
Treatment

Signs and Symptoms

Acute myeloid leukemia (AML) is a cancer of primitive white blood cells in the bone marrow. It is the most common type of acute leukemia seen in adults, accounting for 80 percent of such cases. AML has eight different subtypes that vary in regards to treatment, prognosis and the type of leukemia cell involved. These include:

• M0 - Undifferentiated Leukemia -- Characterized by the overproduction of very primitive leukemia cells or "blasts," which are so immature it sometimes is difficult to tell if they are AML or ALL cells, this leukemia has a poor prognosis and represents less than 5 percent of AML cases.

• M1 - Acute Myeloblastic Leukemia -- This condition is characterized by the overproduction of very primitive white blood cells or "blasts." In turn, the bone marrow contains few mature white blood cells. This leukemia accounts for approximately 15 percent to 20 percent of AML cases.

• M2 - Acute Myeloblastic Leukemia with Maturation -- This condition is characterized by the overproduction of primitive white blood cells or "blasts," where the bone marrow contains mature white blood cells as well as blast. This leukemia accounts for approximately 20 percent to 30 percent of AML cases. A translocation between chromosomes 8 and 21 commonly occurs and suggests a better prognosis.

• M3 - Acute Promyelocytic Leukemia (APL) -- Characterized by the presence of atypical promyelocytes in the bone marrow and peripheral blood, this type of leukemia can be associated with severe bleeding. A translocation between chromosomes 15 and 17 commonly occurs and suggests a better prognosis. This condition represents approximately 10 percent to 15 percent of AML cases.

• M4 - Acute Myelomonocytic Leukemia -- Characterized by the overproduction of monocytes and myelocytes, which are white blood cells that battle infectious agents throughout the body, this type of leukemia represents approximately 20 percent to 25 percent of AML cases.

• M5 - Acute Monocytic Leukemia -- Characterized by the overproduction of white blood cells, monocytes and monoblasts, which are white blood cells that battle infectious agents throughout the body, this type of leukemia represents approximately 5 percent to 10 percent of AML cases.

• M6 - Acute Erythroblastic Leukemia -- Characterized by the overproduction of primitive red blood cells, this leukemia has a poor prognosis and often evolves from a disorder called myelodysplasia. It represents less than 5 percent of AML cases.

• M7 - Acute Megakaryoblastic Leukemia -- Characterized by the overproduction of primitive megakaryocytes (the cells that give rise to platelets), this is a rare from of AML with an extremely poor prognosis.

Typically AML comes on suddenly, within days or weeks. Less often, a patient has been ill for a few months. AML makes people sick primarily by interfering with normal bone marrow function. The leukemia cells replace and crowd out the normal cells of the bone marrow, thereby causing low blood cell counts. This insufficient number of red blood cells results in a condition called anemia, which causes a person to be tired and pale. Lack of platelets can make you more susceptible to bleeding and bruising, especially in the skin, nose and gums.

Lowered levels of normal white blood cells increase the risk of infection. Although infections can be of any type, typical symptoms include:

• Fever
• Runny nose
• Cough
• Chest pain or shortness of breath
• Pain with urinating
• Diarrhea, occasionally

Infections of the bloodstream, called sepsis, and pneumonia are the most dangerous.

Reviewed by health care specialists at UCSF Medical Center.
Last updated May 8, 2007