A life-threatening disorder that predominantly occurs in older adults. Many subtypes exist, of which acute promyelocytic leukaemia merits specific management. Characteristically, abnormal blasts are present in the peripheral blood and normal haematopoiesis is reduced. Definitive diagnosis requires bone marrow biopsy. Presence of blast cells in >20% of the bone marrow cells confirms the diagnosis. Cytogenetic abnormalities are prognostically important and affect patient management. Most patients are treated with chemotherapy induction, consolidation, and maintenance regimens.
Typical symptoms: Patients with AML typically present with a normocytic, normochromic anemia that can vary in severity. This anemia worsens with induction chemotherapy and is managed primarily with blood transfusions. There is no role for the use of erythropoietic stimulating agents during induction therapy of AML.The threshold for transfusion of packed red blood cells varies with patient age, symptoms, and the presence of medical comorbidities. In general, most centers recommend transfusion to asymptomatic patients with a hemoglobin ≤8 g/dL (5 mmol/liter).
Therapeutic aspects: A number of chemotherapy medications are effective against AML. The goal of treatment is to kill the malignant cells without damaging the residual normal bone marrow cells. Studies are underway to find the best medicines, doses, and treatment schedules for AML. Researchers have discovered that the genetic makeup of the abnormal myeloid cells can vary, which affects how you respond to treatment. Your treatment can be tailored based upon a careful analysis of your genetic material. These genetic changes are due to mutations that are acquired within bone marrow stem cells and thereby affect all of the daughter cells that are produced.