Acute Leukemia Research Paper

Acute myelogenous leukemia (AML) is a cancer of the blood and bone marrow, the spongy tissue inside bones where blood cells are made. The word "acute" in acute myelogenous leukemia means the disease's rapid progression. It's called myelogenous leukemia because it affects a group of white blood cells called the myeloid cells, which normally develop into the various types of mature blood cells, such as erythocytes, leukocytes and thrombocytes. A myelocyte is a young cell of the granulocytic series, occurring normally in bone marrow, but not in the circulating blood . Acute myelogenous leukemia is also known as acute myeloid leukemia, acute myeloblastic leukemia, acute granulocytic leukemia and acute nonlymphocytic leukemia.(Mayo Clinic, 2010)
Acute myeloid leukemia (AML) is one of the most common types of leukemia among adults. This type of cancer is rare under age 40 and generally occurs around age 60. Typically AML is more common in men than women. Persons with this type of cancer have abnormal cells inside their bone marrow. The cells grow very fast, and replace healthy blood cells. The bone marrow, which helps the body fight infections, eventually stops working correctly. Individual with AML become more prone to infections and have an increased risk for bleeding as the numbers of healthy blood cells decrease.
There are very few hereditary causes of acute myeloid leukemia. Certain carcinogens (cancer-causing agents) have been implicated in the cause of acute myeloid leukemia, including benzene, tobacco smoke, and ionizing radiation. The most important risk factor for acute myeloid leukemia is advancing age. Acute myeloid leukemia can develop in individuals who have received certain types of chemotherapy to treat other cancers. When this occurs, the leukemia is said to be a secondary acute myeloid leukemia. A pre-leukemic disorder termed myelodysplasia, common in older individuals, is also an important risk factor for acute myeloid leukemia. (Cutler 2005) The pathophysiology in acute myelogenous leukemia (AML) consists of a maturational arrest of bone marrow cells in the earliest stages of development. The mechanism of this arrest is under study, but in many cases, it involves the activation of abnormal genes through chromosomal translocations and other genetic abnormalities. This developmental results in 2 disease processes. First, the production of normal blood cells decreases tremendously, which results in varying degrees of anemia, thrombocytopenia, and neutropenia. Second, the rapid proliferation of these cells, along with a reduction in their ability to undergo programmed cell death (apoptosis), results in their accumulation in the bone marrow, blood, and, frequently, the spleen and liver. (Seiter, 2011
Symptoms that patients with Acute myeloid leukemia include fatigue, fever and recurrent infections, weight loss, night sweats, or bleeding.
Patients are often sick only for days to weeks prior to seeking medical attention. Therefore, the diagnosis of acute myeloid leukemia is made based on a compatible clinical history and a confirmatory laboratory investigation. A complete blood count (CBC) is almost always tested on patients. CBC always comes back abnormal, with leukemic cells often found in the peripheral circulation. Often, the total white blood cell count is elevated, and the red blood cell count is depressed (anemia) as is the platelet count (thrombocytopenia). (Cutler
2005)
There are several way AML is treated, such as chemotherapy, radiotherapy and biological therapy. The goals of therapy are to relieve symptoms and put the AML into remission and hopefully cure the disease. Chemotherapy is the main treatment of AML. Active chemotherapy of leukemia is usually divided into two phases, induction and consolidation. Standard induction therapy for AML includes two drugs: An anthracycline (such as daunorubicin or idarubicin) in combination with the nucleoside analogue, cytosine arabinoside. In the most common induction regiment these drugs are administered intravenously over seven days. Supportive care, which include anti-nauseant medications is required during the initial hospital stay for induction therapy, which often lasts up to one month. The chemotherapy drugs often will kill normal bone marrow and leukemic cells equally, ignificant side effects besides nausea and vomiting are a temporary reduction of normal white blood cells, red blood cells, and platelets.
The lack of white cells results in lowered immunity and a high likelihood of infections. A low platelet count may result in easy bruisability and spontaneous bleeding, and is treated with routine platelet transfusions. A decrease in the red cell count, termed anemia, may result in fatigue, shortness of breath, and lack of energy. Red cell transfusions are therefore used routinely. Consolidation involves giving repeated cycles of chemotherapy once the patient appears to be in remission. The purpose of consolidation chemotherapy is to eradicate any microscopic amounts of leukemia that are undetectable using standard diagnostic studies.Stem cell transplantation is used instead of consolidative chemotherapy in individuals with adverse prognostic features at the time of leukemic diagnosis. Stem cell transplantation is also used in an attempt to cure acute myeloid leukemia that has recurred after standard chemotherapy treatment.(Cutler
2005)
When the signs and symptoms of AML go away, you are said to be in remission. Complete remission occurs in most patients. With treatment, younger patients with AML tend to do better than those who develop the disease at an older age. The 5-year survival rate is much lower in older adults than younger persons. Experts say this is partly due to the fact that the body of a younger person can better tolerate strong chemotherapy medicines.If the cancer does not come back (relapse) within 5 years of the diagnosis, you are considered permanently cured.