Acute nonlymphocytic leukemia (AML)

• prolonged bleeding , bruising easily
• gums, bleeding
• epistaxis ( bleeding from the nose )
• menstrual periods, abnormal
• skin rash or lesion
  • pinpoint red spots ( petechiae )
  • bleeding into the skin
  • bruises ( ecchymoses )

• fatigue
• infection - children under 1 year of age are extremely susceptible to streptococcal septicemia .
• fever
• fatigue
• bone pain or tenderness , tenderness of the breastbone (sternum)
• joint pain
  • hip pain
  • knee pain
  • ankle pain
  • foot pain over small joints of the foot
  • shoulder pain
  • elbow pain
  • wrist pain
  • hand - pain over small joints of the hand

• lymphadenopathy ( enlarged lymph nodes )
• weight loss
• fever
• gums, swollen
• shortness of breath aggravated by exercise
• paleness
• sensations of feeling the heart beat ( palpitations ) with an irregular pattern

Signs and Tests:
A physical examination shows enlarged liver and spleen.

• A WBC count is abnormal.
• A CBC test shows anemia and low platelet count .
• A bone marrow aspiration shows hypercellularity.
• Low reticulocyte counts - Lymphadenopathy

Children have bone and joint manifestations with areas of bone destruction and periosteal elevation by xray.

Treatment:
The objective of treatment is to eliminate the malignant cells with chemotherapy . This process also eliminates normal cells that may be present in the bone marrow. It takes several weeks for the bone marrow to recover and start producing normal cells. During this time supportive care is intensive. It consists of patient isolation to prevent infection, antibiotics to treat infection, transfusions of platelets to control bleeding , and red blood cell transfusions to combat anemia . Intensive chemotherapy, or chemotherapy in conjunction with bone marrow transplant , are potential curative treatments after remission has been achieved.

The FDA has recently approved a new drug called Vesanoid (all-trans retinoic acid) to treat promyelocytic leukemia , a rare but lethal form of AML leukemia. This drug works by causing the leukemic cells to rapidly age and die off, allowing the body to replace them with normal myelocytic cells. In preliminary clinical trials, this drug has resulted in a complete remission in half of the patients who failed standard treatment.

Support Groups:
The stress of illness can often be helped by joining a support group where members share common experiences and problems. See cancer - support group and leukemia - support group .

Prognosis:
Complete remission occurs in 70% to 80% of patients. Long-term survival achieved by curative therapy occurs in 20% to 30% of people. Without treatment, life expectancy is about 3 to 4 months.

Complications:

• relapse of the disease
• severe infection

Call Your Healthcare Provider:
Call for an appointment with your health care provider if symptoms suggestive of AML develop.

Call your health care provider if persistent fever or other signs of infection occur in a person with AML.


This microscope image shows AML cells (acute myeloblastic leukemia; also referred to as ANLL, acute nonlymphocytic leukemia). Certain internal cell structures are typical of AML. These include prominent nucleoli (red arrows) and cytoplasmic granules (grainy structures inside the cell which indicate some degree of cell maturation--black arrow).