TRAINING and EDUCATION
Patient Education
What Are the Risk Factors for AML?
For most people who are diagnosed with AML, there are
no obvious reasons why they developed the disease, but
researchers have identified potential risk factors, including:
• repeated exposure to the chemical benzene, which
damages the DNA of normal marrow cells
• certain genetic disorders such as Down syndrome,
Fanconi anemia, Shwachman-Diamond syndrome,
and Diamond-Blackfan syndrome
• past chemotherapy or radiation treatments for other
cancers
remission (consolidation) and stem cell transplantation,
either using a patient’s own cells (autologous transplant)
or a donor’s cells (allogeneic transplant).
Stem cell transplantation: This may be used with a
second phase of chemotherapy.
Clinical trials: Clinical trials can involve therapy with
new drugs and new drug combinations or new approaches to stem cell transplantation. Taking part in a
clinical trial may be the best treatment choice for some
patients. Clinical trials are underway for patients at every
treatment stage and for patients in remission.
The choice of treatment and resulting outcomes
depend on:
• the AML subtype
• progression of other blood cancers or disorders,
including polycythemia vera, primary myelofibrosis,
essential thrombocythemia, and myelodysplastic
syndrome (MDS)
• the results of cytogenetic analysis
• use of chemotherapy in the past to treat another
type of cancer
What Are the Symptoms of AML?
• the presence of MDS or another blood cancer
Because of the under-production of normal bone marrow cells, it is common for patients with AML to tire
more easily and have shortness of breath during normal
physical activities. Other symptoms include:
• whether the AML has reached the central nervous
system
• pale complexion due to anemia
• signs of bleeding caused by a very low platelet
count, including black-and-blue marks or bruises
occurring for no reason or because of a minor
injury, the appearance of pinhead-sized red spots
on the skin (petechiae), or prolonged bleeding
from minor cuts
• mild fever
• swollen gums
• frequent minor infections
• loss of appetite and weight loss
• whether the AML has not responded to treatment or
relapse has occurred
• the presence of systemic infection at diagnosis
• the patient’s age and general health
Prognosis and Follow-Up Care
After treatment, patients who are in remission and have
completed post-remission (consolidation) therapy continue to be examined regularly by their doctors. Patients’
health, blood cell counts, and marrow should be monitored through careful periodic assessments. As time
progresses, the length of time between assessments may
grow, but assessments should continue indefinitely.
Doctors should also discuss monitoring for long-term
adverse effects or late effects of treatment.
• discomfort in bones or joints
• enlarged spleen
• enlarged liver
In addition, people with AML may experience the following
conditions, which can be dangerous without treatment:
• bleeding in the brain or lung
• infection (especially if your body produces too few
white cells known as neutrophils)
• myeloid sarcoma (when a mass of AML cells can
form a tumor elsewhere in the body)
How Is AML Treated?
38
ASH Clinical News
Cut out and give to a patient
Doctors use several types of treatment for adults with
AML, some at different stages.
Chemotherapy or other drug therapies: Most patients
with AML start chemotherapy right away. The standard
treatment for AML includes high-dose chemotherapy
with a cytarabine/anthracycline combination, followed
by either one to four cycles of chemotherapy after
August 2016