Acute myelogenous leukemia (AML), also known as acute myeloid leukemia, is a cancer of the myeloid line of blood cells. The median age of patients with AML is 70; it is rare among children. The following codes are used with International Statistical Classification of Diseases and Related Health Problems. ... // C00-D48 - Neoplasms (C00-C14) Malignant neoplasms, lip, oral cavity and pharynx (C00) Malignant neoplasm of lip (C01) Malignant neoplasm of base of tongue (C02) Malignant neoplasm of other and unspecified parts of tongue (C03) Malignant neoplasm of gum (C04) Malignant neoplasm of floor of mouth (C05) Malignant neoplasm of... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The International Classification of Diseases for Oncology (ICD-O) is a domain specific extension of the International Statistical Classification of Diseases and Related Health Problems for tumor diseases. ... The International Classification of Diseases for Oncology (ICD-O) is a domain specific extension of the International Statistical Classification of Diseases and Related Health Problems for tumor diseases. ... The Mendelian Inheritance in Man project is a database that catalogues all the known diseases with a genetic component, and - when possible - links them to the relevant genes in the human genome. ... The Diseases Database is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... MedlinePlus (medlineplus. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... Leukemia (leukaemia in Commonwealth English) is a cancer of the blood or bone marrow characterized by an abnormal proliferation of blood cells, usually white blood cells (leukocytes). ... When normal cells are damaged beyond repair, they are eliminated by apoptosis. ... A blood cell is any cell of any type normally found in blood. ...

Myeloid leukemias are characterized as "acute" or "chronic" based on how quickly they progress if not treated. Chronic myelogenous leukemia (CML) is often without symptoms and can remain dormant for years before transforming into a blast crisis, which is markedly similar to AML. Acute may refer to: An acute accent is a diacritic character. ... The word chronic comes from Chronos, the ancient Greek god of time. ... Chronic myelogenous leukemia (or CML) is a form of chronic leukemia characterised by increased production of myeloid cells in the bone marrow. ...

Pathophysiology

Specific chromosomal abnormalities are seen in patients with some forms of AML. These chromosomal abnormalities tend to disrupt genes that encode for transcription factors needed for myeloid stem cells to differentiate into specific blood components. Without differentiation occurring, these myeloid precursor cells fill the bone marrow and spill out into the blood. The overpopulation of the bone marrow with myeloid precursors also results in suppression of normal marrow stem cells, giving rise to the symptoms of anemia (lack of red blood cells), thrombocytopenia (lack of platelets), and neutropenia (lack of neutrophils). In the context of genetics, a transcription factor is a regulatory protein that initiates the transcription of certain genes upon binding with DNA. The binding of a transcription factor to a specific DNA sequence can result in either an increased rate of transcription of the gene, known as activated transcription... Mouse embryonic stem cells. ... This article discusses the medical condition. ... Thrombocytopenia (or -paenia, or thrombopenia in short) is the presence of relatively few platelets in blood. ... It has been suggested that Agranulocytosis be merged into this article or section. ...

Subtypes

World Health Organization (WHO) classification

The World Health Organization (WHO) classification of acute myeloid leukemia (AML) attempts to be more applicable and produce more meaningful prognostic information then the older French-American-British (FAB) criteria, described below. WHO emblem The World Health Organization (WHO) is a specialized agency of the United Nations, acting as a coordinating authority on international public health, headquartered in Geneva, Switzerland. ...

The WHO criteria are:

• AML with characteristic genetic abnormalities, which includes AML with translocations between chromosome 8 and 21 [t(8;21)], inversions in chromosome 16 [inv(16)] and translocations between chromosome 15 and 17 [t(15;17)] (which causes acute promyelocytic leukemia (APL)). Patients with AML in this category generally have a high rate of remission and a better prognosis compared to other types of AML.
• AML with multilineage dysplasia. This category includes patients who have had prior myelodysplastic syndrome (MDS) or a myeloproliferative diseases (MPD) that transforms into AML. This category of AML occurs primarily in elderly patients
• AML and MDS, therapy related. This category includes patients who have had prior chemotherapy and/or radiation and subsequently develop AML or MDS.
• AML not otherwise categorized. Includes subtypes of AML that do not fall into the above categories.
• Acute leukemias of ambiguous lineage. Acute leukemias of ambiguous lineage (also known as mixed phenotype acute leukemia) occur when the leukemic cells can not be classified as either myeloid or lymphoid cells or where both types of cells are present.

Acute myelogenous leukemia (AML), also known as acute myeloid leukemia, is a cancer of the myeloid line of white blood cells. ... The myeloproliferative diseases are a group of diseases of the bone marrow where excess cells are produced. ...

French-American-British (FAB) classification

The older French-American-British (FAB) classification system divided AML into 8 subtypes, M0 through to M7 based on the type of cell from which the leukemia developed and degree of maturity. This is done by examining the appearance of the malignant cells under light microscopy or cytogenetically by characterization of the underlying chromosomal abnormality. Each subtype is characterised by a particular pattern of chromosomal translocations and have varying prognoses and responses to therapy. Although the WHO classification is more useful, the FAB system is still in use. Microscopy is any technique for producing visible images of structures or details too small to otherwise be seen by the human eye. ... A metaphase cell positive for the bcr/abl rearrangement using FISH Cytogenetics is the study of the structure of chromosome material. ... Chromosomal translocation of the 4th and 20th chromosome. ...

The eight different subtypes are:

• M0 (undifferentiated AML)
• M1 (myeloblastic, immature)
• M2 (myeloblastic, mature)
• M3 (promyelocytic), or acute promyelocytic leukemia (APL)
• M4 (myelomonocytic)
• M5 monoblastic(M5a) or monocytic(M5b)
• M6 (erythrocytic)
• M7 (megakaryoblastic)

Acute myelogenous leukemia (AML), also known as acute myeloid leukemia, is a cancer of the myeloid line of white blood cells. ...

Symptoms

Most signs and symptoms of AML are due to the increased numbers of malignant white blood cells and the displacement of normal blood cells from the marrow. A lack of normal blood cell production in the bone marrow makes the patient susceptible to infections due to the lack of normal immune cells, chiefly the so-called neutrophils. The early signs of AML may be similar to those of influenza or other common illnesses, and often have many different signs and symptoms. Some generalized symptoms include: Influenza, commonly known as the flu or the grippe, is a contagious disease of the upper airways and the lungs, caused by an RNA virus of the orthomyxoviridae family. ...

• Fever
• Fatigue
• Weight loss or loss of appetite
• Shortness of breath (dyspnea)
• Anemia
• Easy bruising or bleeding
• Petechiae - flat, pin-head sized spots under the skin caused by bleeding
• Bone pain and joint pain
• Persistent infections

Some patients of AML with subtype M5 may experience swelling of the gums due to the spread of the disease there. See Fever for the Kylie Minogue album; Fever is also a song by Otis Blackwell. ... Two fatigued men in Tehran The word ‘fatigue’ is used in everyday living to describe a range of afflictions, varying from a general state of lethargy to a specific work induced burning sensation within muscle. ... To meet Wikipedias quality standards, this article or section may require cleanup. ... Anorexia (deriving from the Greek όρεξη (orexe) = appetite) is the decreased sensation of appetite. ... Dyspnea (Latin dyspnoea, Greek dyspnoia from dyspnoos - short of breath) or shortness of breath (SOB) is perceived difficulty breathing or pain on breathing. ... This article discusses the medical condition. ... A bruise or contusion or ecchymoses is a kind of injury, usually caused by blunt impact, in which the capillaries are damaged, allowing blood to seep into the surrounding tissue. ... Minor traumatic bleeding from the head Bleeding is the loss of blood from the body. ... A petechia (puh-TEE-kee-uh, plural petechiae puh-TEE-kee-eye) is a small red or purple spot on the body, caused by a minor hemorrhage (broken capillary blood vessels). ... Bone Pain- Bone pain is generally referred to as having pain within the affected bone. ... In medicine, arthralgia (literally: joint pain, from arthros = joint and -algia denoting pain) is the presence of painful joints in the absence of frank arthritis. ... Infection is also the title of an episode of the television series Babylon 5; see Infection (Babylon 5). ...

Occasionally, a person may show no symptoms and the leukemia is discovered during a routine blood test. Usually, the symptoms of AML appear within a few weeks and experience sudden onset of illness.

Diagnosis

Patients with AML usually present with symptoms such as fatigue, bleeding, infection, prompting medical attention. An abnormal blood test reading will then result in further testing in a hospital with a hematologist to determine AML. Most patients with AML will experience a high count of malignant white blood cells, and low counts of red blood cells and platelets. Hematology is the branch of medicine that is concerned with blood and its disorders. ...

A bone marrow aspiration or biopsy is then conducted to identify the type of abnormal blood cells and determine the best treatment plan for the patient. The marrow is taken from the back of the hipbone. Marrow sample aliquots are sent to different test as part of a multidisciplinary process required to establish an accurate diagnosis. Smears are prepared and stained e.g. with Giemsa dye and will give a fair idea of the subtype of leukemia. Labeling live cells with monoclonal antibodies and subsequent analysis in a flow cytometer allows for speedy and accurate diagnosis of AML and for beginning of chemotherapy. Test for molecular changes in turn allow the doctors to establish a prognostic profile of the given patient. A bone marrow biopsy is a medical procedure used as part of a test in the diagnosis of several conditions including leukemia. ...

The presence of Auer rods can distinguish AML from other lymphomas. Auer rods are seen in the leukemic blasts of acute myelogenous leukemia. ...

Because acute promyelocytic leukemia has the highest curability and has a unique form of treatment, it is important to establish or exclude the diagnosis of this subtype of leukemia. This is done by a microscopic (so-called FISH) test, which allows the doctors to demonstrate that the AML is caused by an exchange in chromosomal material between chromosomes 15 and 17 (a so-called balanced translocation, or t(15;17)). Acute myelogenous leukemia (AML), also known as acute myeloid leukemia, is a cancer of the myeloid line of white blood cells. ...

Causes

There is ongoing research into the causes of acute myelogenous leukaemia however it is not known for sure what causes it.

It is thought that in very rare cases, excessive exposure to harmful chemicals such as benzene and radiation such as atomic bomb explosions may trigger abnormal DNA mutations, resulting in leukemia. Patients who have received previous treatment with certain drugs (alkylating agents) are also at higher risk of developing AML. Oral medication A medication is a licenced drug taken to cure or reduce symptoms of an illness or medical condition. ... Alkylating agents are so named because of their ability to add alkyl groups to many electronegative groups under conditions present in cells. ...

Because of inherited genetic defects, some individuals are born with an abnormal immune system, which causes them to be at higher risk of developing leukemia.

Treatment

Chemotherapeutic treatment is divided into two phases: induction and postremission therapy. In all FAB subtypes except M3, the usual initial treatment includes cytarabine (ara-C) and an anthracycline (such as daunorubicin or idarubicin). Because of the toxicity of therapy (from myelosuppression and increased risk of infection), induction chemotherapy is not generally offered to the very elderly. Cytarabine is a shortened form of cytosine arabinoside, a commonly used chemotherapy agent used mainly in the treatment of leukemia and non-Hodgkin lymphoma. ... Anthracycline - Wikipedia, the free encyclopedia /**/ @import /skins-1. ... Daunorubicin is chemotherapy that is given as a treatment for some types of cancer. ... Idarubicin chemical structure Idarubicin or 4-demethoxydaunorubicin is an anthracycline drug that is used in the treatment of cancer. ... Bone marrow suppression is a serious side effect of chemotherapy and certain drugs affecting the immune system such as azathioprine. ...

Complete remission is obtained in about 50-75% of newly diagnosed adults. The bone marrow is examined for malignant cells following induction chemotherapy. Complete remission does not mean that the disease has been cured, but rather, signifies that no disease can be detected (i.e. <5% leukemic blasts in the bone marrow).

Once complete remission is achieved, additional therapy is necessary to eliminate non-detectable disease to prevent relapse of disease and achieve a cure. Postremission therapy can include more intensive chemotherapy, known as consolidation chemotherapy, or bone marrow transplant. However, despite aggressive therapy, only 20-30% of patients enjoy long term disease free survival. For patients with relapsed AML the only proven potentially curative therapy is a stem cell transplant. In 2000, Mylotarg (Gemtuzumab Zogamicin) was approved in the United States for patients over 60 with relapsed AML who are not good candidates for high dose chemotherapy. Bone marrow transplantation (BMT) or hematopoietic stem cell transplantation (HSCT) is a medical procedure in the field of hematology and oncology that involves transplantation of hematopoietic stem cells (HSC). ... Bone marrow transplantation (BMT) or hematopoietic stem cell transplantation (HSCT) is a medical procedure in the field of hematology and oncology that involves transplantation of hematopoietic stem cells (HSC). ...

The M3 subtype, also known as acute promyelocytic leukemia, is almost universally treated by the drug ATRA (all-trans-retinoic acid). For relapsed APL, arsenic trioxide has been tested in trials and approved by the FDA. Like ATRA, arsenic trioxide does not work with other sub-types of AML. Acute myelogenous leukemia (AML), also known as acute myeloid leukemia, is a cancer of the myeloid line of white blood cells. ... Atra or ATRA can refer to: Stachybotrys chartarum All-trans retinoic acid This is a disambiguation page — a navigational aid which lists pages that might otherwise share the same title. ... General Name, Symbol, Number arsenic, As, 33 Chemical series metalloids Group, Period, Block 15, 4, p Appearance metallic gray Atomic mass 74. ... The United States Food and Drug Administration is the government agency responsible for regulating food, dietary supplements, drugs, cosmetics, medical devices, biologics and blood products in the United States. ...

For many AML cases with so-called balanced translocations, it is now possible with molecualr assays (PCR tests) to accurately follow the effect of chemotherapy. In many instances, these quantitative PCR assays have the sensitivity to detect one leukemic cell in 100.000 normal ones. Such data allow the doctors to better evaluate the effect of therapy and to foresee relapses of the disease long before they can be diagnosed by other methods or even felt by the patients.

Famous victims

• Ken Watanabe once fell ill with acute myeloid leukemia in 1989, during the filming of Haruki Kadokawa's Ten to Chi to (Heaven and Earth). Since then he underwent chemotherapy while acting, but experienced a relapse in 1994. Eventually, he fully recovered.

See: Ken Watanabe (actor) Ken Watanabe (astrophysicist) This is a disambiguation page — a navigational aid which lists other pages that might otherwise share the same title. ... Heaven and Earth (天と地と, Ten to chi to) is a 1990 film directed by Kadokawa Haruki starring Enoki Takaaki, Tsugawa Masahiko, Asano Atsuko, Zaizen Naomi and Nomura Hironobu. ...

External links

For more information, see:

• National Cancer Institute (NCI) PDQ statement on AML for health professionals
• Association of Cancer Online Resource (ACOR) Leukemia Links
• Blood & Marrow Transplant Information Network