Leukaemia, acute myeloid 

Leukaemia is cancer of the white blood cells. Symptoms of leukaemia include:

• pale skin
• tiredness
• breathlessness
• having repeated infections over a short space of time

Acute leukaemia means that the condition progresses rapidly and aggressively and requires immediate treatment.

These pages focus on acute myeloid leukaemia (see Types of acute leukaemia).

Bone marrow

All of the blood cells in the body are produced by bone marrow. Bone marrow is a spongy material that is found inside the bones. It is important because it produces special cells that are called stem cells.

Stem cells are very useful because they have the ability to create other specialised cells that carry out important functions. The stem cells in bone marrow produce three important types of blood cells:

• red blood cells – which carry oxygen around the body
• white blood cells – which help fight infection
• platelets – which help stop bleeding

Usually the bone marrow produces stem cells which are allowed to mature into "adult" blood cells. However, in cases of acute leukaemia, the affected bone marrow begins to release a large number of immature white blood cells that are known as blast cells.

The immature white blood cells begin to rapidly disrupt the normal balance of cells in the blood. This means that the body does not have enough red blood cells or platelet cells. This can cause symptoms of anaemia, such as tiredness, and increase the risk of excessive bleeding.

Also, as the white blood cells are not properly formed they become less effective at fighting bacteria and viruses, making you more vulnerable to infection.

If you have acute leukaemia that is left untreated, you will not be able to survive because your blood supply will not function properly.

Types of acute leukaemia

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

• lymphocytes – which are 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 

There are two main types of acute leukaemia that are related to the two main types of white blood cells. They are:

• acute lymphoblastic leukaemia – which is cancer of the lymphocytes
• acute myeloid leukaemia – which is cancer of the myeloid cells

These pages focus on acute myeloid leukaemia (AML). For information on acute lymphoblastic leukaemia, go to the Health A-Z topic on acute lymphoblastic leukaemia

How common is acute myeloid leukaemia?

Acute leukaemia is an uncommon type of cancer. Each year, in England and Wales, an estimated 2,700 new cases are diagnosed. Of these cases of acute leukaemia, about 2,100 are AMLs.

AML is more common in older people, with most cases occurring in people who are 50 or over. For reasons that are not fully understood, acute leukaemia is more common in boys and men than it is in girls and women.

The cause or causes of acute leukaemia are uncertain, but known risk factors include:

• exposure to high levels of radiation
• exposure to benzene, which is a chemical that is used in manufacturing and is also found in cigarettes

Outlook

The outlook for people with AML varies because there are a number of sub-types of AML, and some sub-types are more challenging to treat than others. Some types of AML have a 75% cure rate, while others only have a 20% cure rate. Younger people with the condition tend to have a better outcome than older people.

Treatments for acute leukaemia usually involve a combination of chemotherapy and radiotherapy. In some cases, a bone marrow transplant may also be used to achieve a cure.

If a cure is not possible, there is a risk that the lack of healthy blood cells can make people extremely vulnerable to life-threatening infections (due to the lack of white blood cells) or uncontrolled and serious bleeding (due to the lack of platelets).

In 2009 in England and Wales, there were 2,094 deaths from AML.