What is AML?
Acute myeloid leukaemia (AML) is the less common form of
childhood leukaemia. It is also known as Acute Non-Lymphoblastic
Leukaemia (ANLL). It presents with an excessive growth of abnormal,
immature white blood cells called myeloblasts. This occurs in the
bone marrow, which is the site of all normal blood cell production
(red blood cells, platelets and various types of white blood
cells). The acute prefix means that the disease can progress
rapidly, while a chronic type of disease develops slowly. The
uncontrolled growth of leukaemic myeloblasts can replace the normal
blood cells in the bone marrow and from there they can spread into
the bloodstream. Myeloblasts have the potential to spread to other
organs of the body such as the liver, spleen and lymph glands.
Signs & Symptoms
Children with AML can present with a variety of symptoms namely
pallor, lethargy, fever, easy bruising, pain in the bones or
joints, swollen glands and/or weight loss.
Diagnosis
A full blood examination suggests the diagnosis of AML but a
bone marrow aspirate is necessary to confirm the diagnosis. Other
blood tests, a lumbar puncture and chest Xray will also be
done.
Treatment
Chemotherapy is the primary mode of treatment for AML. As for
ALL parental consent will be sought for your child to be entered on
the appropriate clinical trial. Treatment lasts about six months
and is divided into a number of phases. Two courses of induction
therapy are followed by 2-3 courses of intensive therapy.
Chemotherapy is given orally, intravenously, intramuscularly,
subcutaneously and intrathecally. All courses of therapy are given
as an inpatient. As the therapy is more intensive to that of
therapy for ALL, there is an increased incidence of hospital
admissions and requirements for blood and platelet infusions and
antibiotics for fever and infections.
Depending upon certain clinical, laboratory and molecular
features present at diagnosis and on early response to therapy,
stem cell transplantation may be necessary if a suitable donor is
available. This is usually only performed if remission is
achieved.
AML is now curable in 60% of children. With limitations the
children are encouraged to participate as much as possible in
normal activities and when able to return to school.
Follow up care
Once therapy is completed, there is a regular schedule of follow
up care, to monitor for disease recurrence and the continued growth
and development of the child.