Pediatric Acute Myeloblastic Leukemia (AML)
Acute myeloblastic leukemia (AML) is the 2nd most common form of leukemia found in children, accounting for about 5 percent of all pediatric cancers. Around 500 children in the United States are affected by AML each year. At Ochsner for Children, our Pediatric Hematologists and Oncologists work with a multidisciplinary team to provide state of the art care to children and young adults diagnosed with AML. We are very active in research and clinical trials designed to increase cure rates, decrease treatment-related side effects and improve care for long-term survivors.
What is acute lymphoblastic leukemia?
Acute myeloblastic leukemia (AML) is a cancer that affects the white blood cells. These cells fight infection and help protect the body against disease. Patients with AML have too many immature white blood cells in their bone marrow. These cells crowd out normal white blood cells. Without enough normal white blood cells, the body has a harder time fighting infections. AML affects a type of white blood cell called myelocytes, causing them to build up in the liver, spleen and lymph nodes. There are several different types of AML, some of which require different treatment than others.
What are the symptoms of acute myeloblastic leukemia?
Symptoms of AML include:
- Easy bruising or bleeding that is hard to stop
- Flat, dark-red skin spots (petechiae) due to bleeding under the skin
- Pain in the bones or joints
- Lumps in the neck, underarm, stomach or groin
- Weakness, fatigue, paleness or loss of appetite
- Shortness of breath
How common is acute myeloblastic leukemia?
AML is the 2nd most common type of childhood blood cancer. It affects about 1 in 200,000 children, and about 500 children younger than age 20 are found to have AML each year in the United States. AML is much more common in adults.
What are the survival rates for acute myeloblastic leukemia?
- About 90 percent of children with AML go into remission after induction treatment.
- 5 year survival rates for AML range from 65-75%
- Certain types of AML may have significantly higher or lower cure rates.
The diagnosis of acute myeloblastic leukemia in children is based on a complete medical history and physical examination and on the following diagnostic tests:
- Complete blood count (CBC). Blood drawn is used to look at the white blood cell number, as well as platelets. Blood tests may be done to evaluate the liver and kidneys and how the blood is clotting.
- Bone marrow aspirate and biopsy. Bone marrow aspirates and biopsies involve inserting a needle into a bone in the pelvis and removing about 2 teaspoons of marrow for examination. Bone marrow studies usually require sedation or general anesthesia.
- Lumbar puncture (spinal tap). Spinal taps involve inserting a needle into the lower back, between the bones of the spinal column or backbone, to remove the fluid that surrounds the brain and spinal cord. The same needle can be used to insert medicines to prevent or treat leukemia in the brain or spinal cord (intrathecal chemotherapy). Lumbar punctures are often done under sedation.
- Chest X-ray. Chest X-rays are taken to see if there is a mass of cells in the thymus that may affect breathing.
How is acute myeloblastic leukemia treated?
AML treatment includes two phases:
- Induction — The purpose of this phase, which often occurs in the hospital, is to kill the leukemia cells in the blood and bone marrow and put the disease into remission (a return to normal blood cell counts).
- Consolidation/intensification — The purpose of this phase is to rid the body of any remaining cells that could begin to grow and cause the leukemia to relapse. Stem cell transplant may also be considered in some cases during this phase.
Four types of treatment may be used during any of these treatment phases:
- Chemotherapy (“chemo”)—uses powerful medicines to kill cancer cells or stop them from growing (dividing) and making more cancer cells.
- Stem cell transplant — This involves destroying the blood forming cells in the bone marrow with high-dose chemotherapy and radiation, then replacing them with cells from a donor
- A stem cell transplant gives the patient new blood cells and a new immune system from a donor’s blood or bone marrow.
- Some types of stem cell transplants may be called “bone marrow transplants” because the cells come from the donor’s bone marrow.
- Radiation therapy — While infrequently used, high-energy X-rays or other types of radiation can kill cancer cells or stop them from growing.
- Targeted therapy — Newer medicines are now available that target and attack specific cancer cells without harming normal cells. Many of these medicines are still considered experimental.
What clinical trials does Ochsner Hospital for Children offer for leukemia treatment?
- As part of the Children’s Oncology Group, Ochsner Hospital for Children is an active participant in children’s cancer research. We currently have multiple clinical trials available to treat children and young adults with leukemia.