Acute myeloid leukemia is a heterogeneous cancer of the blood and bone marrow. This tumor occurs as a result of an over production of immature white blood cell which is called myeloblast.

The name of the disease is gotten from the blood cell produced in excess. The immature white blood cell produced gets into the bone marrow and it’s over production hinders the production of the normal blood cells.

The main cause of the display of these symptoms is as a result of the loss of normal function of blood by these myelobast. Since they are immature and reduce the mature and proper functioning blood, their function as blood cells is greatly reduced. One of the functions of blood affected in acute myeloid leukemia is fighting against infection.

Patients with acute myeloid leukemia are easily infected due to reduced immunity against infection. Another very common symptom in patients suffering from acute myeloid leukemia is anemia. Anemia is as a result of reduced production of normal red blood cells and platelets. Anemia is usually severe with different levels of severity seen in different patients. Acute myeloid leukemia has other symptoms like being easily bruised and having swollen gum, bleeding of the nose, fever, skin pallor and even shortness of breath.

The treatment of acute myeloid leukemia in a newly diagnosed patient consist of chemotherapy ( the type of chemotherapy used is age dependent) aimed to quickly induce total remission, when this is achieved, further therapy is then aimed at cure of the disease (by eliminating any undetected residuals of the leukemic cells). Therefore the treatment process is divided into two stages.

The first stage is the stage of induction. The goal of this therapy is to get complete remission by reducing the quantity of the leukemic cells in the bone marrow and circulating blood to an undetectable level. The commonly used complete remission induction is a combined chemotherapy of cytarabine and anthracycline. Cytarabine is administered intravenously with dosage of 100 – 200mg/m2/day for one week. Anthracycline consists of daunorubicin is administered intravenously 45-60mg/m2 on day1, 2, and 3.

When induction therapy is completed, the bone marrow is examined. If blast cells are more than 5% with up to 20% cellular cells, induction therapy is performed again with dose similar to the first but cytarabine is given for 5 and antracycline 2 days. But after the second therapy if there is no positive result stem cell transplant is considered, though this is only possible in patient younger than 65 years.

The second stage is post remission or consolidation therapy, which is aimed at cure of patients with acute myeloid leukemia after the leukemic cells becomes undetectable. In this therapy treatment is based on the patient’s condition, this therapy involves an additional intensive chemotherapy of 3 to 5 courses. Patients with high risk of cytogenetics are given allogeneic stem cell transplant. Patients who stem cell transplant is not suitable for, are treated with a combination therapy of histamine dihydrochloride (ceplene) and interleukin 2.

The treatment of acute myeloid leukemia has shown good prognosis in the time past especially if diagnosis is made early ant treatment is started immediately.

By Dave Morrison

Myeloid leukemia is a group of diseases whose characteristic changes are seen in the bone marrow and blood, where tumor cells infiltrate the blood system; sometimes these cells even spill into the circulating blood other tissues. The concept of myeloid leukemia is from the action of immature white blood cells being produced in excess and therefore inhibiting the production of the normal blood cells. These cells are called myeloid cells; they by their action in the blood disturb the function of the blood cells.

This leukemia has both tumors which are kept untreated to those that are diagnosed and treated immediately, ranging from rapid fatality to those which are slow in growing. Therefore on the basis of their treatment course they are divided into acute myeloid leukemia (AML) and chronic myeloid leukemia (CML).

AML is seen more in men than in women and more prevalent in people older than 65 than in people of younger age. CML is also greater in men than in women but its incidence always increase slowing and the people’s age increases and gets to the peak of occurrence in mid forties from where there is rapid rise in CML occurrence. Anyway the incidence of CML decreased slightly in the past two decades.

The etiology of myeloid leukemia is depended on the type, AML is related with risk factors such as hereditary (other resident blood disease in the family history; DIC) exposure to occupational chemicals, intense exposure to radiation which may be as a result of therapeutic reasons and even some drugs, but there is nothing relating the cause of ML to viral infection in any way.

While the etiology of chronic myeloid leukemia has no distinct relation with cytotoxic drug effect and there is also no evidence connecting it with any viral infection, but cigarette smoking by studies has shown to increase its progress into severe crisis, therefore living with Chronic myeloid leukemia and smoking becomes dangerous. Only large dosage of radiation has any adverse effect for CML formation.

The symptoms of ML are also depending on the type, whether it is AML or CML. For AML patients are presented with some nonspecific symptoms which begin either slowly or abruptly and the symptoms are leucopenia or leucocytosis, thrombocytopenia. These symptoms are usually due to anemia in such patients. Other symptoms of are fatigue, anorexia and weight loss and easily getting bruised with excessive bleeding.

While in CML the symptoms are at first insidious therefore it is difficult to diagnose a patient based but symptoms, such patients are usually diagnosed during normal medical checkup, or others come to the hospital with complaints fatigue, weight loss, symptoms relating to splenomegaly such as early satisfaction during eating, left upper quadrant pain, infections, thrombosis or sometimes bleeding.

When chronic myeloid leukemia progresses symptoms worsened with bone and joint pain, significant loss of weight which will require increasing the dose of the drugs used for treatment. Chemotherapy is used as treatment of myeloid leukemia but when this fails bone transplant is done.