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Understanding AML

Types

Research into acute myeloid leukemia has advanced in recent years, making it clear that acute myeloid leukemia is not a single disease, but rather a disease that can take one of many forms. The type of acute myeloid leukemia a patient has can depend on:

  • how developed the abnormal leukemia cells are at diagnosis;
  • the shape (morphology) of the leukemia cells and specific markers (proteins) on their surface;
  • how much they differ from normal, healthy blood cells;
  • the genetic/chromosomal abnormality present; and
  • whether the leukemia has relapsed.1

The type of acute myeloid leukemia a patient has can impact how well certain treatments work; knowing your acute myeloid leukemia type can guide personalized treatment decisions.

Genetic changes in acute myeloid leukemia

Changes to specific genes, known as mutations, are identified in many cases of acute myeloid leukemia and can result in specific types of acute myeloid leukemia. These mutations can help abnormal cells grow in an out-of-control manner. Some mutations are associated with better outcomes, while others are thought to contribute to more aggressive forms of acute myeloid leukemia and poorer outcomes.

Changes in the following genes are most commonly observed in patients with acute myeloid leukemia: FLT3, IDH1, IDH2, NPM1, DNMT3A, CEBPA, TET2, and KIT. It is important to know whether one or more of these genes are abnormal in your acute myeloid leukemia cells, as this can identify the type of acute myeloid leukemia you have and help to tailor a unique treatment for you.

Ask your doctor about your specific type of acute myeloid leukemia.

Chromosomal changes in acute myeloid leukemia

There are several categories of chromosomal changes that can cause specific types of acute myeloid leukemia. These can affect your outlook and how you respond to treatment. They include

  • chromosomal translocations – when part of a chromosome breaks off and sticks to a different chromosome;
  • chromosomal deletions – when part of a chromosome is lost, possibly leading to the loss of a gene that controls the growth of blood cells;
  • chromosomal inversions – when the chromosome is flipped, resulting in faulty ‘instructions’ within the blood cell, which can lead to abnormalities; and
  • chromosomal additions and duplications – when there is an extra chromosome that can produce an abnormal gene.

Knowing the chromosomal changes that are present in your acute myeloid leukemia can help leukemia specialists decide the best treatment option for you.

Acute promyelocytic leukemia

Acute promyelocytic leukemia is a unique type of acute myeloid leukemia, which is most common in adults between 20 and 50 years of age.2 Acute promyelocytic leukemia is characterized by a very specific chromosomal change, whereby sections of chromosomes 15 and 17 switch, forming an abnormal fusion gene called PML/RARα. This abnormal gene can lead to the overproduction of immature, non-functional white blood cells called promyelocytes. These promyelocytes build up in the bone marrow and reduce the number of mature healthy blood cells.

References

1. Cancer.Net. Leukemia - Acute Myeloid - AML: Subtypes. https://www.cancer.net/cancer-types/leukemia-acute-myeloid-aml/subtypes. Accessed Feb 24, 2021.

2. Leukemia & Lymphoma Society. Acute Promyelocytic Leukemia Facts. https://www.lls.org/sites/default/files/National/USA/Pdf/Publications/APL_FactSheet_10_15FINAL.pdf. Accessed Feb 24, 2021.

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What is acute myeloid leukemia?Causes & symptomsDiagnosisTypesTreatmentPrognosisRemissionRelapseCOVID-19Caregivers

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