hematology and oncology
Acute Myeloid Leukemia (AML)
Introduction
In acute myeloid leukemia (AML), malignant transformation and uncontrolled proliferation of an abnormally differentiated, long-lived myeloid progenitor cell results in high circulating numbers of immature blood cells and replacement of normal marrow by malignant cells. Symptoms include fatigue, pallor, easy bruising and bleeding, fever, and infection; symptoms of extramedullary leukemic infiltration are present in only about 5% of patients (often as skin manifestations). Examination of peripheral blood smear and bone marrow is diagnostic. Treatment includes induction chemotherapy to achieve remission and postremission chemotherapy (with or without stem cell transplantation) to avoid relapse. (See also Overview of Leukemia .) TheAmerican Cancer Societyestimates that in the United States in 2023 there will be about 20,000 new cases of acute myeloid leukemia (AML) and about 11,300 deaths , almost all in adults. AML is slightly more common among men than women, but the average lifetime risk in both sexes is about 0.5% (1 in 200 Americans). AML comprises about 25% of childhood leukemias, often developing in infancy. However, the incidence of AML increases with age; it is the most common acute leukemia in adults, with a median age of onset of 68 years. AML also may occur as a secondary cancer after chemotherapy or radiation therapy for a different type of cancer. Secondary AML is difficult to treat with chemotherapy alone. 