Acute myeloid leukaemia 

Introduction 

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Leukaemia is cancer of the white blood cells. Acute leukaemia means the condition progresses rapidly and aggressively, requiring immediate treatment.

Acute leukaemia is classified according to the type of white blood cells that are affected. There are two main types:

  • lymphocytes  mostly used to fight viral infections
  • myeloid cells  which perform a number of different functions, such as fighting bacterial infections, defending the body against parasites and preventing the spread of tissue damage 

These pages focus on acute myeloid leukaemia (AML), which is an aggressive cancer of the myeloid cells. The following types of leukaemia are covered separately:

Signs and symptoms of acute myeloid leukaemia

The symptoms of AML usually develop over a few weeks, and become increasingly more severe. Symptoms can include:

  • pale skin
  • tiredness
  • breathlessness
  • frequent infections
  • unusual and frequent bleeding, such as bleeding gums or nosebleeds

In more advanced cases, AML can make you extremely vulnerable to life-threatening infections or serious internal bleeding.

Read more about the symptoms of AML and complications of AML.

Seeking medical advice

You should see your GP if you or your child have possible symptoms of AML. Although it is highly unlikely that leukaemia is the cause, these symptoms should be investigated.

If your GP thinks you may have leukaemia, they will arrange for blood tests to check your white blood cells. If this test suggests there is a problem, you will be urgently referred to a haematologist (a specialist in treating blood conditions) for further tests and any necessary treatment.

Read more about diagnosing AML.

What causes acute myeloid leukaemia?

AML occurs when specialised cells called stem cells, which are found in the bone marrow (a spongy material inside the bones), produce excessive numbers of immature white blood cells. These immature cells are known as blast cells.

Blast cells don't have the infection-fighting properties of healthy white blood cells, and their excessive production can lead to a decrease in the number of red blood cells (which carry oxygen in the blood) and platelets (cells that help the blood to clot).

It is not clear exactly why this happens, although a number of factors that can increase your risk of developing AML have been identified. These include:

  • exposure to very high levels of radiation, including previous treatment with radiotherapy
  • exposure to benzene  a chemical used in manufacturing that is also found in cigarette smoke
  • having an underlying blood disorder or genetic condition (such as Down's syndrome)

Read more about the causes of AML.

Who is affected

AML is an uncommon type of cancer. Around 2,600 people are diagnosed with the condition each year in the UK.

AML can develop at any age, but it's more common in people over the age of 60.

How acute myeloid leukaemia is treated

AML is an aggressive type of cancer that can develop rapidly, so treatment usually needs to begin soon after a diagnosis is confirmed.

The main treatment for AML is chemotherapy, which is used to kill as many leukaemia cells in your body as possible and reduce the risk of the condition coming back (relapsing).

In some cases, intensive chemotherapy and radiotherapy may be needed, in combination with a bone marrow or stem cell transplant, to achieve a cure.

Read more about treating AML.

Outlook

The outlook for AML largely depends on the specific type of AML you have, your age and general health.

There are many subtypes of AML, which are classified according to a number of features – such as the specific genetic changes in the leukaemia cells. Some types of AML are more challenging to treat than others.

Even if treatment is initially successful, there remains a significant risk that the condition will return at some point during the next few years. If this happens, treatment may need to be repeated.

A number of recent medical trials have suggested that almost half of those aged under 60 diagnosed with AML will live for at least five years, and in some types of AML, such as acute promyeloid leukaemia (APML), around 85% will live for at least five years.

In general, the outlook for children with AML tends to be better than that of adults diagnosed with the condition.

Page last reviewed: 23/05/2014

Next review due: 23/05/2016

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Comments

The 9 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Stokienomad said on 21 July 2014

My father passed away from this on July 16th just 27 hours after being diagnosed with it. He was 75 and very fit and had a routine blood test two weeks earlier which came up clean. On the days leading up to this he went off his food and felt tired and had difficulty walking and after going to hospital two days before he died he was told he had a water infection! And given antibiotics. The consultant on the cancer ward said he hadn't ever seen such an aggressive case as this. Hope this helps.

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bloodanon said on 24 April 2012

@michjohnson

SCA is caused by a defect in the gene that codes for haemoglobin. Haemoglobin is only turned on in your red blood cells.
Leukaemia is when your white blood cells go wrong.
Becuase your white blood cells never need to turn on the haemoglobin gene, it doesn't matter to them if it is defective.

SCA doesn't see to alter your chances of getting leukaemia according to this report.
Am J Hematol. 2003 Dec;74(4):249-53.
Malignancy in patients with sickle cell disease.
Schultz WH, Ware RE.

short answer: the gene mutation that causes SCA is unrelated to cancer of your white blood cells (leukaemia)


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chatsubo said on 16 September 2011

Haematologist / Nickysayshello

The information re incidence and mortality stats are correct, and if you check the latest data you will see an even tighter correlation.

ONS Death Stats for 2009 give 2,094 deaths from AML in 2009 in E&W

Cancer Research give 2,095 new cases of AML in 2008 (last year for which data is available.)

Spooky I know, but then as they teach you in the first week of medical school incidence isn't the same as prevalence.

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Haematologist said on 03 September 2011

Nickysayshello seems to be saying that each year all the new cases and 100 of the old ones die. The figures given cannot all be correct. Please could NHS Choices try to sort this out.

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Nicksayshello said on 22 August 2011

I assume that the 1900 death consists of new (1800) and existing (100+) cases of AML.

The cure rate statement seems quite straight forward though.

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Haematologist said on 01 August 2011

"Of these cases of acute leukaemia, about 1,800 are AMLs"

"Some types of AML have a 75% cure rate, while others only have a 20% cure rate"

" there is an average of 1,900 deaths from AML".

Confusing!!

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Diddi said on 05 January 2011

my big sis has it, and has been told she may die in the next 52 hrs or live forever without rthe leukemia, what are the chances of her survival????

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bec89 said on 05 January 2010

My 11 year old sister was diagnosed with ALL leukaemia in christmas 08 and now she has finished her first year of treatment, and has started her second year. The only thing i wanted to mention was that we wanted to know as a family, of what were the chances of it coming back?
We were told 25% (obviously this was for my sister im not sure on other cases). After this we chatted to some of the parents whos childrens ALL leukaemia had come back over a few years. None of them were told what the chances of it coming back was. I think parents should be made aware of this in the same way you are told about the chances of being infertile. I mean this is a constructive way and i could never show my appreciation enough towards the NHS staff at St James ward 10.

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michjohnson said on 01 September 2009

I would like to know if leukaemia is related to sickle cell anemia.

Thanks

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