Acute Myeloid Leukemia (AML)

Acute myeloid leukaemia (AML) is the term used to describe malignant changes in the bone marrow. It originates in the immature precursors of red blood cells, platelets and some white blood cells. AML is the most common form of acute leukaemia in adults. Whereas in the past it was considered almost incurable, the chances of recovery have improved considerably today. AML is a disease of haematopoietic stem cells, or more precisely of myelopoiesis. This is the part of the hematopoietic system responsible for the formation of granulocytes, monocytes, erythrocytes and megakaryocytes. 

The word acute means that leukaemia cells occur as immature, undifferentiated cells. A large proportion of blasts can be detected in the bone marrow.

AML leads to a partly massive proliferation of immature blood cells in the bone marrow and in the majority of cases also in the blood (leukocytosis). The leukemic cells spread into bone marrow and blood and can also infiltrate lymph nodes, the spleen and other organs, and in rare cases the central nervous system. The immediate consequence is a suppression of normal haematopoiesis. There is a lack of erythrocytes, blood platelets and functional mature granulocytes.

AML is a rare disease with about three new cases per year. On average, patients are over 60 years old at diagnosis. AML accounts for about 80 percent of all acute leukaemias in adults. Men are affected slightly more frequently than women.

As with all cancers, the cause is unique to each patient. Possible risk factors are ionising radiation and certain chemical substances.

The symptoms

The symptoms of AML develop in most cases within a few weeks. They are caused by the lack of normal blood cells on the one hand and by the invasion of organs with myeloid blasts on the other. Patients complain of fatigue, exhaustion, loss of appetite, reduced performance, paleness, shortness of breath, general weakness, unexplained fever and general discomfort. The reduction of white blood cells often leads to an increased susceptibility to infections. The reduction of thrombocytes (thrombopenia) can also cause bleeding, unexplained bruises, nosebleeds and unusually long bleeding after injuries, as well as bleeding of the gums. Swelling of the lymph nodes occurs in the neck, armpits or groin, and joint and bone pain can result from the spread of blasts in the bones.

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