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Leukemia is a cancer of the white blood cells that spreads throughout the bloodstream and may affect many organs. It originates in the bone marrow (spongy center of bones), which is where all blood cells are developed before being released into the bloodstream. Leukemia is classified based on the type of abnormal white blood cell and by how rapidly these cells leave the bone marrow and enter the bloodstream. Acute myeloid leukemia (AML) is the most common type of leukemia that affects adults. The December 22/29, 2010, issue of JAMA includes an article about the association between genetic characteristics of leukemia cells and outcomes of the disease. This Patient Page is based on one published in the June 10, 2009, issue of JAMA.
Fevers with night sweats
Swollen or bleeding gums
Loss of appetite
Enlarged liver or spleen
Bone or joint pain
Complete medical history and physical examination
Bone marrow aspiration and biopsy (taken with a needle, usually from the hip)
Echocardiogram (ultrasound) of the heart
Treatment is determined by
The age of the patient and differs for those younger than 60 compared to those older than 60
Whether the patient has received prior chemotherapy
Whether the patient has other medical problems
Treatment is carried out in 2 phases:
Induction uses chemotherapy to induce remission (normal-appearing blood and bone marrow).
Consolidation therapy is used to achieve a long-lasting remission. The type of treatment offered in this phase depends on the response to the treatment used in the induction phase.
Consolidation therapy options include
Stem cell transplant from the patient himself or herself in remission (autologous) or from an identical twin (syngenic)
Allogeneic stem cell transplant from a matched healthy donor
Investigational (within a clinical trial) therapy
Centers for Disease Controland Preventionhttp://www.cdc.gov/nceh/radiation/phase2/mleukemi.pdf
National Cancer Institutehttp://www.cancer.gov/cancertopics/pdq/treatment/adultAML/patient
To find this and other JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish. A Patient Page on acute lymphoblastic leukemia was published in the January 28, 2009, issue and one on cancer clinical trials was published in the June 9, 2004, issue.
Sources: Centers for Disease Control and Prevention, National Cancer Institute
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.
TOPIC: BLOOD DISEASES
Hildreth CJ, Lynm C, Glass RM. Acute Myeloid Leukemia. JAMA. 2010;304(24):2759. doi:10.1001/jama.302.22.2759
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