Acute Myeloid Leukemia (Pediatric)

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What is acute myeloid leukemia?

Childhood acute myeloid leukemia (AML) is a cancer of the bone marrow, which is sometimes called the body’s “blood factory,” because bone marrow is where blood cells are created. In AML, the bone marrow makes a large number of abnormal blood cells. The cells that normally become white blood cells don’t fully develop. These immature white blood cells are called myeoblasts.

The myeoblasts, or leukemia cells, begin in the blood, but can spread to other parts of the body, including the brain, spinal cord, skin, and gums. Sometimes, these cells can form a solid lump or tumor called a granulocytic sarcoma (also called a chloroma). It is thought that a number of factors can affect the risk of developing AML, including having had chemotherapy for a previous illness, certain types of radiation, exposure to cancer-causing chemicals such as benzene, having Down syndrome, and some genetic disorders.

Signs and symptoms of AML include fever, weakness, easy bruising, bone or joint pain, skin rashes and the appearance of chloromas. When a patient has these symptoms and a blood test uncovers an abnormal blood cell count, the health care provider will suspect that the patient has AML.

Our approach to acute myeloid leukemia

In order to confirm the diagnosis, the health care provider must remove some of the bone marrow and examine whether it contains leukemia cells (myeoblasts). There are a number of other tests available to help the health care provider tell what type of AML the patient has.

It may be necessary to perform a lumbar puncture (also known as a spinal tap), to detect whether cancer cells exist in the fluid in the spine (cerebrospinal fluid or CSF). In this procedure, a needle is carefully inserted into part of the spine in the lower back to collect fluid to be examined. This procedure is performed under light, general anesthesia to make the patient more comfortable.

The treatment of AML is intensive, aggressive chemotherapy, (a treatment through which medicines are given that attack the cancer cells), along with a regimen of antibiotics, transfusions, and nutrition, which help the patient maintain their health through the process. In some cases, newly developed medicines called targeted therapies and immunotherapies, which use immune cells to attack the cancer, have been used. In some cases, patients may also require a stem cell transplant to help restore the bone marrow.