Acute myelogenous leukaemia (AML) is a malignant disease of the bone marrow in which hematopoietic precursors are arrested in an early stage of development. The American Cancer Society estimates that 20,830 new cases of AML (12,730 in men, 8100 in women) will occur in the United States in 2015, accounting for 32% of all leukemia cases in adults 20 years of age and older. AML is more commonly diagnosed in developed countries, and it is more common in whites than in other populations.
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 abnormalitiesFirst, the production of normal blood cells markedly decreases, which results in varying degrees of anaemia, 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, the blood, and, frequently, the spleen and liver.
Current standard chemotherapy regimens cure only a minority of patients with AML. As a result, all patients should be evaluated for entry into well-designed clinical trials. If a clinical trial is not available, the patient can be treated with standard therapy. For consolidation chemotherapy or for the management of toxic effects of chemotherapy, readmission is required.When receiving chemotherapy, patients should avoid exposure to crowds and people with contagious illnesses, especially children with viral infections. Any patient with neutropenia fever or infection should immediately be treated with broad-spectrum antibiotics.