Round Table Replay: AML Essentials, Here’s What You Need to Know, Part 1

This HealthTree Round Table for AML took place on February 13th, 2023 

Topic: AML Essentials, Here’s What You Need to Know (Part 1) 

Experts: Dr. Pamela Becker, City of Hope, Dr. Gabriel Mannis, Stanford, Dr. Dan Pollyea, University of Colorado

Part 1 - AML 101 with Dr. Mannis

Here's a recap of Dr. Mannis' presentation:

What is AML:

• The A stands for acute: symptoms usually occur quickly (2-3 months or less). Treatment is often initiated urgently
• The M stands for myeloid: this refers to the subtype of blood cell affected 
• The L stands for leukemia: a cancer of blood cells, this is defined by more than 20% blasts (leukemia cells) in the blood or bone marrow 

Normal bone marrow cells are spread out, so blasts are less than 5% of the entire population inside the marrow. In leukemia, blasts go above 20%, so red blood cells, platelets, and white blood cells are either very low or very high.

Symptoms are:

• Fever
• Infections 
• Anemia 
• Fatigue 
• Trouble breathing
• Easy bruising

How did I get this?

• 60% of cases are random mutations as we age
• 30% of cases are due to environmental factors: prior chemotherapy/radiation, pre-existing bone marrow problem (MDS, chronic leukemia)
• 10% of cases are inherited (this means that, 90% of them are not!)

Is it curable?

• Treatment consists of reaching remission which means there is no detectable leukemia and blood counts are normal 
• Chemotherapy consists of: induction and consolidation (with or without maintenance treatment)

There is a possibility of a cure! For some patients, when leukemia is gone, it never comes back. Age and genetics (some chromosome and gene changes) are two factors that affect whether or not a cure is likely.

How is it treated?

In elderly people: 

• Lower intensity treatments - which cause fewer potential side effects
• Outpatient treatment
• Repeat cycles every month
• Consider stem cell transplant depending on the patient

In younger and/or "fit" people:

• Higher intensity treatment - which causes more potential for side effects
• Time-limited treatments - usually requires spending at least a month in the hospital
• Most patients are considered for a bone marrow transplant

What to expect during treatment:

• Anemia
• Low platelets
• Low white blood cells
• Nausea, diarrhea, constipation
• Fatigue 
• Hair loss 
• Anxiety

What can I do as a patient?

• Stay active if possible
• Eat enough to maintain adequate calorie intake day to day
• Train your brain as well!

What else should I ask?

• What is my risk level?
• What is my prognosis? 
• Is a cure possible for me?
• What is the standard treatment and what are the common side effects?

Stay tuned. Part 2, Developing a Personalized Treatment Strategy, will be published next week! 

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