Acute Myeloid Leukemia—Child
(AML—Child; Acute Myelogenous Leukemia—Child; Acute Myeloblastic Leukemia—Child; Acute Granulocytic Leukemia—Child; Acute Nonlymphoblastic Leukemia—Child)En Español (Spanish Version)
Leukemia is a type of cancer that develops in the bone marrow. With acute myeloid leukemia (AML), the bone marrow makes abnormal myeloid cells that are precursors to blood cells, including:
- Myeloblasts (a type of white blood cell) that fight infection
- Red blood cells that carry oxygen
- Platelets that make blood clots and stop bleeding in cuts and bruises
The leukemia cells do not function normally. They cannot do what normal blood cells do, like fight infections. The abnormal cells also overgrow the bone marrow, forcing normal cells out. Without normal cells, anemia and bleeding problems develop. They also cannot fight infections properly.
Risk factors include:
- Having a sibling, especially an identical twin, who develops leukemia
- Having a genetic condition (eg, Down syndrome )
- Exposure to radiation
- Exposure to certain chemicals (eg, benzene, a chemical used in the cleaning and manufacturing industries)
- History of other blood disorders (eg, polycythemia vera , essential thrombocytosis, myelodysplastic syndrome
- Race: Hispanic
- Frequent infections
- Shortness of breath
- Paleness (a sign of anemia)
- Easy bruising or bleeding
- Petechiae (flat, pinpoint spots under the skin caused by bleeding)
- Weakness, fatigue
- Loss of appetite, weight loss
- Bone and joint pain
- Painless lumps in the neck, underarms, stomach, or groin
- Bleeding gums
These symptoms may be due to other conditions. If your child has any of these, talk to the doctor.
The doctor will ask about your child’s symptoms and medical history. A physical exam will be done. The doctor will check for swelling of the liver, spleen, and lymph nodes. Tests may include:
- Blood tests—to check for changes in the number or appearance of different types of blood cells
- Bone marrow biopsy or aspiration—removal of a sample of liquid bone marrow and a small piece of bone to test for cancer cells
- Lumbar puncture (spinal tap)—removal of a small amount of cerebrospinal fluid to check for cancer cells
- Cytogenetic analysis—a test to look for certain changes in the chromosomes (genetic material) of the lymphocytes
- Immunophenotyping—examination of the proteins on cell surfaces and the antibodies produced by the body
- Chest x-ray —x-rays of the chest that may detect signs of lung infection or cancer in the chest
- CT scan —a type of x-ray that uses a computer to make pictures of structures inside the body
- MRI scan —a test that uses magnetic waves to make pictures of structures inside the body
- Gallium scan and bone scan —injection of a radioactive chemical into the bloodstream to detect areas of cancer or infection
- Ultrasound—a test that uses sound waves to examine masses and organs inside the body
Once AML is identified, it can be classified. These subtypes are based on the type of cell from which leukemia developed. This is important because it can help the doctor make a prognosis and develop a treatment plan.
Bone Marrow Biopsy
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Talk with the doctor about the best plan for your child. Treatment of AML usually involves two phases:
- Remission induction therapy—to kill leukemia cells
- Maintenance therapy—to kill any remaining leukemia cells that could grow and cause a relapse
Treatment options include:
- External beam radiation therapy—targets a certain part of the body
- Stem cell transplant —replaces the affected bone marrow with healthy bone marrow
- Other drug therapy (eg, arsenic trioxide, All-trans retinoic acid [ATRA])—may be used to kill leukemia cells, stop them from dividing, or help them mature into white blood cells
- Biological therapy—involves using medicine or substances made by the body to increase or restore the body’s natural defenses against cancer
- Antibiotics to treat and prevent infections
- Medicines to treat anemia and side effects (like nausea and vomiting)
American Cancer Society
National Cancer Institute
BC Cancer Agency
American Cancer Society. Leukemia in children detailed guide. American Cancer Society website. Available at: http://www.cancer.org/Cancer/LeukemiainChildren/DetailedGuide/index . Accessed July 13, 2010.
Children’s Hospital Boston. Leukemia. Children’s Hospital Boston website. Available at: http://www.childrenshospital.org/az/Site1236/mainpageS1236P0.html . Accessed July 13, 2010.
DynaMed Editorial Team. Acute myeloid leukemia (AML). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated July 13, 2010. Accessed July 14, 2010.
Mayo Clinic. Acute myelogenous leukemia. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/acute-myelogenous-leukemia/DS00548 . Updated July 8, 2010. Accessed July 14, 2010.
McCoy K. Acute myelogenous leukemia. EBSCO Health Library website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15topicID=81 . Updated June 25, 2010. Accessed July 14, 2010.
Last reviewed June 2011 by Kari Kassir, MD
Last updated Updated: 6/6/2011
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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