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  Leukemia, Acute Myelogenous (AML)  
 
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About 10,600 new cases of acute myelogenous leukemia are diagnosed each year in the United States. Acute myelogenous leukemia (AML) may be called by several names, including: acute myelocytic leukemia, acute myeloblastic leukemia, acute granulocytic leukemia or acute nonlymphocytic leukemia. AML results from acquired (not inherited) genetic damage to the DNA of developing cells in the bone marrow. The effects are: 1) the uncontrolled, exaggerated growth and accumulation of cells called "leukemic blasts" which fail to function as normal blood cells and 2) the blockade of the production of normal marrow cells, leading to a deficiency of red cells (anemia), and platelets (thrombocytopenia) and normal white cells (especially neutrophils, i.e., neutropenia) in the blood.

In most cases the cause of AML is not evident. Several factors have been associated with an increased risk of disease. These include:

  • Exposure to high doses of irradiation, as carefully studied in the Japanese survivors of atomic bomb detonations
  • Exposure to the chemical benzene, usually in the work place
  • Exposure to chemotherapy used to treat cancers such as breast cancer, cancer of the ovary or the lymphomas.
AML is not contagious and is not inherited. Uncommon genetic disorders such as Fanconi anemia, Down syndrome and others are associated with an increased risk of AML. About 15 percent of childhood leukemia cases are of acute myelogenous leukemia. Older people are more likely to develop the disease. AML incidence increase dramatically among people who are over the age of 40. They are most prevalent in the sixth, seventh and eighth decades of life.

AML can occur in a variety of ways; different types of cells may be seen by the physician in blood or marrow. Since most patients have one of seven different patterns of blood cell involvement, these patterns have formed a subclassification. Myeloblasts are undeveloped cells. If they are the dominant leukemic cells in the marrow at the time of diagnosis the leukemia is referred to as "myeloblastic" type. If there are many myeloblasts but there are some cells developing towards fully formed blood cells, the added designation "with maturation" is used. If there are cells that are developing features of monocytes ("monocytic" type) or red cells ("erythroleukemic"), these designations are used and so forth.

Even though the leukemia cells look somewhat like blood cells, the process of their formation is incomplete. Normal, healthy blood cells are insufficient in quantity.

The subclassification of the disease is important. Different types of therapy may be used and the likely course of the disease may be different. Additional features may be important in guiding the choice of therapy, including: abnormalities of chromosomes, the cell immunophenotype, the age and the general health of the patient, and others.

Most patients feel a loss of well-being. They tire more easily and may feel short of breath when physically active. They may have a pale complexion from anemia. Several signs of bleeding caused by a very low platelet count may be noticed. They include black-and-blue marks or bruises occurring for no reason or because of a minor injury, the appearance of pin-head sized spots under the skin, called petechiae, or prolonged bleeding from minor cuts. Mild fever, swollen gums, frequent minor infections like pustules or perianal sores, slow healing of cuts or discomfort in bones or joints may occur.

To diagnose the disease the blood and marrow cells must be examined. In addition to low red cell and platelet counts, examination of the stained (dyed) blood cells with a light microscope will usually show the presence of leukemic blast cells. This is confirmed by examination of the marrow, which invariably shows leukemic blast cells. The blood and/or marrow cells are also used for studies of the number and shape of chromosomes (cytogenetic examination), immunophenotyping and other special studies, if required.

Courtesy of the Leukemia and Lymphoma Society.
 

 
 

Conditions that suggest Leukemia, Acute Myelogenous (AML):
 
 
Lab Values  Monocytes Elevated

Organ Health

  Enlarged Spleen
 
 

Risk factors for Leukemia, Acute Myelogenous (AML):
 
 
Circulation  Thrombocytosis
 Evolution of primary thrombocytosis to frank acute myeloblastic leukemia (AML), myelofibrosis/AMM, or myelodysplastic syndrome (MDS) has been documented in adults and represents a progression of disease.
 
 

Leukemia, Acute Myelogenous (AML) suggests the following may be present:
 
 
Nutrients  Zinc Requirement
 It was found that the copper to zinc ratio was significantly higher in patients with lymphoma or acute and chronic leukemias compared to control subjects. A person at increased risk of one of these cancers should check blood levels of copper and zinc to rule out abnormalities and make adjustments accordingly. Since zinc and copper are antagonistic, and zinc deficiency is relatively common, supplemental zinc is often used to improve this ratio. Zinc helps block the absorption of copper and acts to remove accumulated copper from the body as well as prevent its accumulation. [Rev. Invest. Clin, Nov-Dec. 1995;47(6): pp.447-52]
 
 

Recommendations for Leukemia, Acute Myelogenous (AML):
 
 
Lab Tests/Rule-Outs  Test Copper Levels
  Test Zinc Levels
 
 


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GLOSSARY

Acute:  An illness or symptom of sudden onset, which generally has a short duration.

Anemia:  A condition resulting from an unusually low number of red blood cells or too little hemoglobin in the red blood cells. The most common type is iron-deficiency anemia in which the red blood cells are reduced in size and number, and hemoglobin levels are low. Clinical symptoms include shortness of breath, lethargy and heart palpitations.

Cancer:  Refers to the various types of malignant neoplasms that contain cells growing out of control and invading adjacent tissues, which may metastasize to distant tissues.

Chemotherapy:  A treatment of disease by any chemicals. Used most often to refer to the chemical treatments used to combat cancer cells.

Chronic:  Usually Chronic illness: Illness extending over a long period of time.

Copper:  An essential mineral that is a component of several important enzymes in the body and is essential to good health. Copper is found in all body tissues. Copper deficiency leads to a variety of abnormalities, including anemia, skeletal defects, degeneration of the nervous system, reproductive failure, pronounced cardiovascular lesions, elevated blood cholesterol, impaired immunity and defects in the pigmentation and structure of hair. Copper is involved in iron incorporation into hemoglobin. It is also involved with vitamin C in the formation of collagen and the proper functioning in central nervous system. More than a dozen enzymes have been found to contain copper. The best studied are superoxide dismutase (SOD), cytochrome C oxidase, catalase, dopamine hydroxylase, uricase, tryptophan dioxygenase, lecithinase and other monoamine and diamine oxidases.

DNA:  Deoxyribonucleic acid, the large molecule that is the main carrier of genetic information in cells. DNA is found mainly in the chromosomes of cells.

Leukemia:  Cancer of the lymph glands and bone marrow resulting in overproduction of white blood cells (related to Hodgkin's disease).

Lymphoma:  Any tumor of the lymphatic tissues.

Thrombocytopenia:  Condition of abnormally small number of platelets circulating in the blood, characterized by inability to properly clot blood and easy bruising.

Zinc:  An essential trace mineral. The functions of zinc are enzymatic. There are over 70 metalloenzymes known to require zinc for their functions. The main biochemicals in which zinc has been found to be necessary include: enzymes and enzymatic function, protein synthesis and carbohydrate metabolism. Zinc is a constituent of insulin and male reproductive fluid. Zinc is necessary for the proper metabolism of alcohol, to get rid of the lactic acid that builds up in working muscles and to transfer it to the lungs. Zinc is involved in the health of the immune system, assists vitamin A utilization and is involved in the formation of bone and teeth.