AML is one of the most common types of leukaemia. Though treatment is aggressive and expensive, certain sub-types have a better survival rate
From Sleepless in Seattle to Julie and Julia, Nora Ephron had created a permanent place in all our minds. Her recent death shocked many admirers of her work. Nora Ephron, 71, had been diagnosed with myelodysplastic syndrome that ultimately turned into acute myeloid leukaemia.
According to Dr Satya Dattatreya Palanki, consultant medical oncologist, Omega Hospitals, “Acute myeloid leukaemia (AML) is cancer that starts inside the bone marrow. The cancer grows from cells that would normally turn into white blood cells.”
Dr Niti Raizada Narang, consultant medical hem-oncologist, Fortis Hospitals and Vikram Hospitals, Bangalore adds that AML is a blood cancer in the myeloid cells of the blood cells. Although the specific cause cannot be determined it could be due to radiation, chemicals, weakened immune system and blood disorders, explains Dr Dattatreya. Talking about the occurrence, Dr Niti says, “AML can be seen in any decade of one’s life but it usually can be seen in people in the age group of 50 and above.” Dr Dattatreya mentions that this type of cancer is more common in men.
Talking about diagnosis, Dr Niti says, “AML does not have specific symptoms. One may notice symptoms such as fever that is taking time to be cured and is not being cured by regular medication. During such a situation the doctor may advice for a blood test that reveals an unusual WBC count. The other symptoms could be bleeding manifestations, bone pains and fatigue.”
Dr Dattatreya adds, “The other symptoms could include bleeding from the nose or gums, bruising, bone pain, fever, heavy menstrual periods, pallor, shortness of breath, skin rash, swollen gums and weight loss”
Dr Niti says, “A bone marrow test can help diagnose AML. But AML as such is a crude diagnosis. A genetic subtype test is done to find out what kind of AML it is. AML can be of different. Thus the treatment will also vary on the type of AML.” There are a total of eight types of AML. The type depends upon what kind of blood cell is abnormal.
Dr Niti says, “In case of AML we see a 20-30 per cent chances of complete curability. The treatment for AML itself is very intensive. Many a times in High Risk AML, stem cell transplant is required.” In most cases chemotherapy is the basic treatment for the various types of AML.
Dr Dattatreya mentions that the other treatments for AML could include antibiotics, RBC transfusion and platelet transfusion. He says, “When the signs and symptoms of AML go away and the bone marrow examination reveals normalcy, the patient is said to be in remission. Complete remission occurs in most patients. With treatment, younger patients with AML tend to do better than those who develop the disease at an older age. The 5-year survival rate is much lower in older adults than younger persons. Experts say this is partly due to the fact that the body of a younger person can better tolerate strong chemotherapy medicines.”
By 5-year survival rate, it means that if the cancer does not come back within five years of diagnosis the person is completely cured.
Dr Dattatreya mentions that M1, M2 and M4 are the most common types. When it comes to AML-M3 patients have a more than 75 per cent chance of complete cure unlike all the other AMLs where the cure rates are between 25 – 40 per cent.
Dr Niti mentions that in many cases because of the absence of clear symptoms by the time the patient comes to the hospital they are in a poor condition and treatment is aggressive and expensive. It is important that the hospital where the patient is treated has adequate and good facilities. Mortality in AML can be because of the illness itself or because of treatment.
Although the ailment cannot be prevented Dr Dattatreya says, “If you work around radiation or chemicals linked to leukemia, you should wear protective gear.”