ACUTE MYELOID LEUKEMIA (AML) Presented by Judi McCarter Clinical Overview • Acute myeloid leukemia (AML) is one of four types of leukemia. • AML is cancer of the blood-forming tissue (bone marrow). • Normal bone marrow produces red cells, white cells, and platelets. • AML causes bone marrow to produce too many immature white blood cells (blast cells). • Suppresses normal blood cell production. – Anemia, leucopenia, thrombocytopenia Clinical Overview • AML is acquired from genetic damage to the DNA of a single cell in the bone marrow; resulting in malignancy. • Diagnosed by clinical laboratory tests performed on blood and bone marrow. • Primarily affects adults and children younger than one year old. • Incidence is 2.5 out of 100,000 people. Signs and Symptoms • Fatigue • Shortness of breath on exertion • Easy bruising • Petechiae • Bleeding in the nose or from the gums • Prolonged bleeding from minor cuts • Recurrent minor infections or poor healing of minor cuts • Loss of appetite or weight loss • Mild fever Statistics Incidence: 11,920 new cases expected in U.S. in 2004 Mortality: 8,870 estimated deaths – 2004 M:54%, F:46% Prognosis: 5-year survival rate in adults under 65 is 33% Prognosis: 5-year survival rate in adults over 65 is 4% Prognosis: 20-30% experience remission or are cured Sources: American Cancer Society, 2003; The Leukemia & Lymphoma Society, 2003 Risk Factors • Age – Older adults are more likely to develop AML • Smoking – 20% of AML cases are linked to smoking – Doubles the risk of disease in people older than 60 • Genetic disorders – Down syndrome, Fanconi’s anemia • High doses of radiation – Long-term survivors of atomic bombs • Previous chemotherapy treatment – Breast cancer, ovarian cancer, lymphoma • Exposure to industrial chemicals – Benzene Treatments for AML • Chemotherapy Phase One – Remission induction therapy Phase Two – Remission continuation therapy • Radiation therapy for certain cases • Bone marrow transplantation Prognosis for AML • Survival rates greatly improved over past 25 years. • Majority of patients still succumb to the disease. • Remission rates inversely related to age. – 5-year survival rate in adults under 65 is 33% – 5-Year survival rate in adults over 65 is 4% • Dependent upon several factors. – Age – White blood cell count – Presence of translocations in bone marrow The Future • Clinical trials • New drug treatments • Vaccines • Immunotherapy • Leukemia type-specific therapy • Gene therapy – Block encoding instructions of an oncogene – Target the oncoprotein • Blood and marrow stem cell transplantation – Bone marrow transplantation provides long-term, disease-free survival among patients in remission Jillian had leukemia. She was only one year old. She needed a transplant, but no one in her family was a match. Joe had joined the Registry at the encouragement of a friend. Brought together by the National Marrow Donor Program, this donor and recipient now have a life-long connection. http://www.marrow.org 1-800-4MY-SDBB 1-800-469-7322 Questions?? Thank you.
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