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     Presented by Judi McCarter
              Clinical Overview
• Acute myeloid leukemia (AML) is one of four types of
• AML is cancer of the blood-forming tissue (bone marrow).
• Normal bone marrow produces red cells, white cells, and
• 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
• 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

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.
1-800-4MY-SDBB   1-800-469-7322

 Thank you.

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