Acute myeloid leukemia

Overview

Acute myeloid leukemia (AML) is the most common type of acute leukemia in adults.  It is a disease in which the bone marrow makes abnormal myeloblasts (a type of white blood cell).  This type of cancer usually gets worse quickly if it is not treated.

Our approach

Northwell Health takes an advanced approach to treating acute myeloid leukemia (AML). Northwell Health's Hematologic Oncology Center, home to the Adult Bone Marrow and Stem Cell Transplant Programs and the only FACT-accredited program in Long Island, Queens and Brooklyn, is one of the largest in the New York metropolitan area. The highly regarded experts use the latest technology and research-backed therapies to treat newly diagnosed, relapsed and refractory acute myeloid leukemia.

The Hematologic Oncology Center has advanced molecular biology diagnostic tests to classify conditions in order to determine the best treatment. As one of the largest university programs in the United States for acute leukemia diagnosis and treatment sponsored by both the National Cancer Institute (NCI) and the pharmaceutical industry, the center is able to offer both standard and innovative treatments for this disease. Center physicians hold leadership roles on national committees involved in developing and improving treatment protocols.

Highlights of Northwell Health acute myeloid leukemia treatments and services include:

  • Personalized acute myeloid leukemia treatments from a team of physicians with extensive experience with hematologic malignancies.
  • Advanced therapies that deliver the best outcomes with the least impact on the body, including National Cancer Institute and highly selected pharmaceutical industry-sponsored clinical trials.
  • FACT-accredited bone marrow/stem cell transplantation program for patients who require transplantation.

Multidisciplinary Acute Myeloid Treatment

Within the first several days of a patient visit, the multidisciplinary team at the Hematologic Oncology Center will conduct comprehensive tests and develop a personalized cancer treatment program.

Each diagnosis is unique, so the physician team meets regularly to discuss the treatment of each patient. The team holds weekly multidisciplinary conferences where acute myeloid leukemia oncologists at the cancer center share ideas and best practices for delivering collaborative patient care. The specialists review each treatment phase to constantly monitor and improve acute myeloid leukemia care and ensure treatment milestones are reached.

Symptoms

The early signs of AML may be like the flu or other common diseases. A doctor should be contacted if someone has any of the following problems:

  • Weakness or a tired feeling 
  • Fever or night sweats
  • Petechiae (flat, pinpoint spots under the skin, caused by bleeding)
  • Headaches
  • Shortness of breath
  • Easy bruising or bleeding

Be aware that these symptoms could be due to conditions other than acute myeloid leukemia, so it’s best to see a doctor right away if someone is experiencing them.

Diagnosis

The first step to making an acute myeloid leukemia diagnosis is usually a physical exam. A doctor will also consider personal and family medical history. If acute myeloid leukemia is suspected, the patient will be sent for additional tests — usually administered on an outpatient basis — which include:

  • Complete blood count (CBC) with differential — Blood is drawn to measure the number of red blood cells, white blood cells and platelets in the blood. The amount of hemoglobin (substance in the blood that carries oxygen) and the hematocrit (the amount of whole blood that is made up of red blood cells) are also measured. The differential will count the different types of white blood cells that may be present.
  • Peripheral blood smear — A blood sample is checked for blast cells (immature cells from bone marrow, an increase of which could be a sign of leukemia), the number and kinds of white blood cells, the number of platelets and changes in the shape of blood cells.
  • Bone marrow aspiration and biopsy — A small sample of bone marrow and bone is removed. The sample is examined by a pathologist for signs of leukemia.
  • Immunophenotyping — A process used to identify cells based on the types of antigens or proteins on the surface of the cell. This process is used to diagnose specific types of leukemia and lymphoma by comparing cancer cells to their normal counterparts. Flow cytometry and immunohistochemistry are the two tests used to provide optimal immunophenotyping.
  • Blood chemistry studies — A blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that makes it.
  • Cytogenetic analysis — The chromosomes in the cells of a blood or bone marrow sample are examined. Abnormalities in the chromosomes could be a sign of acute or other kinds of leukemia. Cytogenetics and a related procedure called fluorescence in-situ hybridization (FISH) are used to identify whether or not abnormal chromosomes are present. 
  • Molecular genetics — The molecular genetics laboratory looks for expressions of disease that may have escaped detection by other methods. 
  • Lumbar puncture (spinal tap) — If a diagnosis of leukemic meningitis is suspected, then during the course of treatment, a thin needle called a spinal needle is put into the lower part of the spinal column to collect cerebrospinal fluid. If the cancer has spread, leukemia cells may be found. Chemotherapy drugs can be given directly through the spinal needle.

Recurrent acute myeloid leukemia

Recurrent acute myeloid leukemia is leukemia that has recurred (returned) after going into remission. The AML may come back in the blood, bone marrow, or other parts of the body.

With the data from these state-of-the-art tests for acute myeloid leukemia diagnosis, a doctor will develop a customized treatment plan to achieve the best possible outcomes.

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