ICD-10 Disease Code: C92.0 Acute myeloblastic leukemia
ICD-10 Disease Group: C92 - Myeloid leukemiaGeneral description:
Acute myeloid leukaemia (AML) may occur when the bone marrow produces unusually large numbers of diseased blood cells. These cells include red blood cells, white blood cells and platelets. AML is a type of cancer that escalates quickly in severity, and early treatment is therefore critical for maximising the chances of survival.
AML is the most common type of acute leukaemia in adults. The 5-year survival rate for people 20 and older with AML is 26%. For people younger than 20, the survival rate is 68%. However, survival depends on several factors, including biologic features of the disease and, in particular, a patient's age.Mutations:
AML is caused by a mutation in the genome of the stem cells found the bone marrow that are responsible for generating blood cells. This causes an increased production of immature white blood cells that are unable to fight infections effectively. The disease is known to be associated with at least 17 different mutations, and the risk of developing AML is greatly increased if patients have previously received radiation treatments for other cancers.Disease frequency:
According to cancer.gov, AML accounts for about 1% of all cancers. In the U.S. AML affects 4-5 people per 100,000.
The disease is slightly more prevalent in males than in females.Symptoms:
Symptoms of AML typically appear when the immature white blood cell counts become high enough to nversely affects the populations of healthy red blood cells and platelets. Early symptoms may be experienced as flu-like, with patients experiencing coughs, fever and weakness. Later on, the symptoms evolve to paleness of the skin, easier bruising and excessive bleeding as the platelet count diminishes.
The disease is often diagnosed by performing physical examinations and complete blood counts (CBC). For a CBC a sample of blood is drawn from the patient and the sample is then examined by doctors to establish the counts of red blood cell, platelets, haemoglobin and white blood cells.Treatment:
Treatment of AML is separated into two phases:
Remission induction therapy: The first phase of the treatment is focused on getting the cancer in remission. This is achieved by killing the leukaemia cells in the the blood and bone marrow, causing the leukaemia to go into remission.
Post-remission therapy: The second phase of treatment is initiated after the leukaemia is confirmed to be in remission. Here, the goal is to target any remaining leukaemia cells in the body, which are not yet active, but could reinitiate the development of AML.
These phases are generally carried out through 4 different types of treatments:
Chemotherapy: These drugs are usually injected into the bone marrow or brain, depending on the development of the disease.
Radiation therapy: This treatment uses a machine emitting high energy x-rays targeted at specific cancer sites in the body to kill the cancer cells.
Chemotherapy + stem cell transplant: As chemotherapy is at risk of causing damage to healthy cells as well as cancer cells, stem cells can be transplanted in order to replenish the blood forming cells in the bone marrow.
Targeted therapy: Targeted therapy uses drugs to specifically target tumor-associated cells causing less damage to healthy cells in the progress. These include monoclonal antibody treatments to combat the tumor cells. Other targeted treatments exist for AML caused by mutations in specific genes like the FLT3 gene. An example of this treatment is Gilteritinib, a tyrosine kinase inhibitor used in patients unresponsive to conventional treatments.Sources: