What are the first AML symptoms?

The first symptoms of acute myeloid leukaemia are usually related to a decrease in the function of normal blood cells in the bone marrow.
.

Patients typically present with symptoms related to low red blood cells (anaemia) – such as breathlessness, tiredness, frequent infections (due to lowered or non-functional white cells), and bruising easily (due to low platelet counts). There are also less specific symptoms such as night sweats, unintended weight loss, or swelling of glands in the neck and groin.
.

If you notice several of these symptoms developing over a few weeks, seek the advice of a medical professional for a proper diagnosis.
..

How fast does acute myeloid leukaemia progress?

The symptoms of acute myeloid leukaemia (AML) often develop over a few weeks to a few months before patients actually become symptomatic. Once patients are symptomatic with abnormalities in their blood counts, then treatment for AML is often a medical emergency with urgent stabilisation required.
..

Can AML be asymptomatic?

Acute myeloid leukaemia may be asymptomatic at an early stage of detection. However, the condition progresses over a typical period of several weeks- months. Once the AML becomes more advanced, almost all patients experience symptoms varying from lethargy, shortness of breath, increased infections to easy bleeding or bruising.
..

Does AML affect the brain?

Unlike acute lymphoid leukaemia (ALL), which often may involve the brain and the central nervous system, acute myeloid leukaemia (AML) rarely affects the brain or the spine or central nervous system.
..

Can acute myeloid leukaemia spread to other parts of the body?

AML is a fast-progressing and aggressive form of cancer. Unlike most cancers that affect solid organs, AML is a liquid cancer of the white blood cells. As such, often the only organ involved in the blood system itself. 
.

AML cells can occasionally spread to other organs and parts of the body. For example, acute myeloid leukaemia may spread to the testicles, spleen, spinal cord, brain, liver, and lymph nodes. 
..

How long before symptoms of acute myeloid leukaemia start to show?

Symptoms of acute myeloid leukaemia may appear 4 to 6 weeks prior to diagnosis. As AML is known to be an aggressive form of cancer, the onset and progression of symptoms happen quickly. However, symptoms such as tiredness or infection may be mistaken for those caused by more common diseases, such as the flu. It is important that you seek medical advice if these symptoms persist. 
..

What organs does AML affect?

Acute myeloid leukaemia (AML) is a fast-growing and often aggressive form of cancer. Unlike most cancers that affect solid organs, AML is a liquid cancer of the white blood cells. As such, often the only organ involved in the blood system itself. However, on occasion, the AML cells may spread to other organs like the spleen, testicles, brain, and spinal cord.
..

How can acute myeloid leukaemia be prevented?

The majority of acute myeloid leukaemia cases are idiopathic in nature, as in, there is no identifiable cause. As such, there are no known ways to prevent the majority of AML.
.

Some patients develop AML after prior treatment with chemotherapy or radiotherapy for another primary cancer (AML occurring in this situation is known as secondary AML). Rarely AML may also occur in patients who had prior occupational exposure to certain cancer-causing agents (carcinogens) or in patients who have had accidental exposure to high doses of radiation.
.

Smoking is one of the controllable risk factors of acute myeloid leukaemia, although the impact of smoking on AML is not high. However, quitting smoking will help reduce a person’s risk of developing AML.
..

Are you born with acute myeloid leukaemia?

The vast majority of acute myeloid leukaemia cases are not inherited. There are, however, some rare genetic conditions such as Down’s syndrome and Fanconi’s anaemia which may increase one’s risk of developing leukaemia from birth.
..

What are the risk factors for acute myeloid leukaemia?

Currently, it is known that prior exposure to radiation and certain carcinogenic chemicals are significant risk factors for the development of acute myeloid leukaemia. However, other risk factors include:

1. Smoking
2. A background of other blood disorders such as myelodysplastic syndromes or advanced myeloproliferative disorders (such as myelofibrosis).
3. Rare genetic syndromes (such as Down’s syndrome or Fanconi’s anaemia).
4. A family history, although AML only very rarely, is inherited. 
   .

.Is myelofibrosis associated with acute myeloid leukaemia?

Myelofibrosis is a form of blood cancer where there is an excessive production of scar (fibrotic) tissue in the bone marrow. Patients often develop low blood counts over time with an enlarged spleen.
.

In patients with advanced myelofibrosis, this blood condition can progress to acute myeloid leukaemia. Patients with AML arising from a background of myelofibrosis have a poorer prognosis. 
.

Is AML worse than ALL?

Acute myeloid leukaemia (AML) and acute lymphoblastic leukaemia (ALL) are both serious forms of blood cancer. The prognosis for both conditions is poorer in adults when compared to children.
.

Acute lymphoblastic leukaemia is the most common form of childhood cancer. Significant advances have been made in the treatment of children with ALL, and in countries such as Singapore, 80-90% of children can be successfully treated with combination chemotherapy and targeted therapy.
.

What is the difference between acute and chronic myeloid leukaemia?

Leukaemia is a cancer that begins in the blood-forming cells of one’s bone marrow. Depending on whether the abnormal cells are mature or immature, you have either acute or chronic leukaemia. 
.

The primary difference between acute myeloid leukaemia and chronic myeloid leukaemia is that the onset of AML is fast and aggressive, while CML generally progresses more slowly. Unlike AML, the majority of CML cases can be successfully managed with targeted oral therapy.
..

What are the stages of acute myeloid leukaemia?

As acute myeloid leukaemia is a liquid cancer, it is not classified in stages like the way solid cancers are usually.
.

AML is classified by risk categories (poor risk, standard risk and favourable risk). This is determined by the genetics of the AML at the time of diagnosis by looking at tests such as the cytogenetics and AML specific molecular panel. 
.

Can chronic myeloid leukaemia turn into acute myeloid leukaemia?

The primary difference between acute myeloid leukaemia (AML) and chronic myeloid leukaemia (CML) is that the onset of AML affects immature stem cells in the bone marrow and is a fast and aggressive form of blood disorder. On the other hand, CML affects the more mature forms of white cells in the bone marrow and tends to progress more slowly.
.

Most forms of CML are of an early stage (CML chronic phase) and can be very effectively treated with oral targeted therapies. However, in some cases, chronic myeloid leukaemia develops into a more advanced stage, and occasionally CML can transform into acute myeloid leukaemia. This form of CML, known as blast-phase CML, occurs less commonly since the start of the targeted era of drug therapies for CML.
..

What can I expect with acute myeloid leukaemia?

In most cases, the diagnosis of AML often comes as a shock to the patient. AML is a serious medical condition, and you will face months of treatment ahead. It is important that you are physically and mentally prepared for this battle ahead. Our team of experienced doctors and nurses at CFCH will help to support you and your family through your treatment journey.  
.

The symptoms of acute myeloid leukaemia often develop over a period of weeks to months as the leukaemia cells gradually increase and affect the function of the normal healthy cells in the bone marrow. 
.

Sometimes AML is detected by abnormalities on a routine blood test. These abnormalities are typically reflected in the full blood count.
.

Patients may also present with symptoms due to an ineffective bone marrow. The symptoms may include:

1. Lethargy
2. Shortness of breath
3. Dizziness or fainting
4. Increased infections or poor healing
5. Easy bruising or bleeding
6. Unexplained weight loss
7. High fevers
8. Swollen lymph glands
   .

How long can you survive with acute myeloid leukaemia?

Treatment options for acute myeloid leukaemia have improved significantly over the last decade with improved diagnostics as well as several novel, new drugs now available. Bone marrow transplantation remains the main curative option for patients with aggressive acute myeloid leukaemia.
.

Historically, only 20% of patients with acute myeloid leukaemia will survive for 5 years or more following their diagnosis. However, this is determined by several factors, of which the most important factors are:

1. the patient’s age and
2. the prognostic group of the patient as determined by cytogenetics and molecular risk factors.
   .

Younger patients often survive longer than older ones. For example, roughly 65% of patients under the age of 14 will survive their leukaemia for 5 years or more following their diagnosis, while amongst patients older than 65 years of age, less than 10% will survive for more than 5 years.
..

How long can you live with AML without treatment?

Acute myeloid leukaemia is an aggressive form of cancer and requires immediate treatment. Unfortunately, without proper treatment, patients may be given a prognosis of less than 6 months, with a major cause of death being related to infections or bleeding.
..

Can acute myeloid leukaemia be cured?

Acute myeloid leukaemia is an aggressive and fast-growing cancer. A patient’s outcome depends on the type of AML they are diagnosed with, their individual health, and recommended treatment plan. 
.

While many cases of AML can be cured with treatment such as chemotherapy or a bone marrow transplant, the outcomes still depend on the patient’s age and fitness, as well as the AML risk groups.
.

For patients with standard risk AML, approximately 50% of patients may be successfully treated with existing treatments. For patients with favourable risk AML, approximately 60-70% of patients may have a durable remission. However, for patients with poor risk AML, the chances of a durable remission are less than 25%.
..

How long is the treatment for AML leukaemia?

Intensive chemotherapy remains the treatment of choice for younger and fitter AML patients. Some of these patients may also need an allogeneic haematopoietic stem cell transplantation. As such, the treatment for AML may last for up to 6 months.
.

In older patients or patients who are not fit for intensive chemotherapy or transplantation, treatment is often less intensive. However, in these cases, while the treatment is usually better tolerated, the duration of treatment is often continuous, with the aim to control the patient’s disease.
.

How many rounds of chemo are needed for leukaemia?

For patients who need intensive chemotherapy for treatment of their acute myeloid leukaemia, they will typically receive 4-5 cycles of intensive therapy. Each session of chemotherapy may last for 4 weeks. 
.

Patients who are receiving intensive chemotherapy followed by transplantation typically receive 2-3 cycles of chemotherapy before undergoing the bone marrow transplantation.
.

Patients who are not fit for intensive chemotherapy or transplantation may receive continuous cycles of non-intensive targeted therapy.
.

The specific treatment protocols for each AML patient often varies based on individual factors, and our doctors at CFCH will discuss your personal AML treatment plan in detail with you. 
.

Can AML be cured without chemotherapy?

Unfortunately, even with chemotherapy and the latest available novel therapies, only a portion of AML patients can be successfully cleared of their disease.
.

Even with newer, targeted novel therapies, the vast majority of leukaemia cases require a combination of novel agents with conventional chemotherapy and sometimes even a bone marrow transplantation for successful clearance of the AML.
.

Do you need chemotherapy before a stem cell transplant?

Acute myeloid leukaemia is usually a liquid cancer, only involving the blood system and bone marrow.
.

However, acute myeloid leukaemia can sometimes present with solid tumours known as a myeloid sarcoma or chloroma. These tumours can develop anywhere in the body. It is often referred to as extramedullary disease. Patients with these solid tumour forms of AML often have a more aggressive form of leukaemia.
..

How long can you live with multiple myeloma after a stem cell transplant?

The symptoms of acute myeloid leukaemia often develop over a period of weeks to months as the leukaemia cells gradually increase and affect the function of the normal healthy cells in the bone marrow. 
.

Sometimes AML is detected by abnormalities on a routine blood test. These abnormalities are typically reflected in the full blood count.
.

Patients may also present with symptoms due to an ineffective bone marrow. The symptoms may include:

1. Lethargy
2. Shortness of breath
3. Dizziness or fainting
4. Increased infections or poor healing
5. Easy bruising or bleeding
6. Unexplained weight loss
7. High fevers
8. Swollen lymph glands
   .

Should you have any of these symptoms, you should seek medical attention for a proper evaluation and accurate diagnosis.
...

How much does acute myeloid leukaemia treatment cost in Singapore?

The cost of AML treatment varies depending on several factors, including: 

1. The treatment drugs needed (non-intensive vs intensive chemotherapy vs targeted therapy)
2. Presence of pre-existing complications, such as active infection.
3. Whether the patient requires a bone marrow transplantation.
4. Whether the patient requires in-patient or out-patient therapy.
   .

Our doctors at CFCH will assess your medical condition and advise you on the best treatment plan going forward. Based on this, you will be provided with a detailed breakdown of the cost estimates for your therapy. 
.

Why is AML so hard to treat?

Acute myeloid leukaemia is a liquid cancer affecting the white cells of the body. The white cells are responsible for our immunity and protecting our bodies from infections. 
.

Patients with acute myeloid leukaemia often are at a higher risk of infection-related complications due to their faulty immune system, and due to the fact that the chemotherapy given has to wipe out the defective immune system before a healthy one can recover.
.

In addition, AML occurs at a higher incidence in older patients, where they may not be as fit to tolerate existing therapies. In addition, AML is usually more aggressive in older patients.
.

Finally, even with present therapies, including novel targeted agents and advances in bone marrow transplantation, AML is an aggressive cancer with a high rate of relapse even in cases after successful initial treatment. 
.

How often do leukaemia patients need blood transfusions?

AML patients most usually need transfusions at the beginning of their treatment when the AML has been diagnosed. This is when the burden of leukaemia cells is the largest in the bone marrow, and the normal production of red cells in the bone marrow is suppressed.
.

Patients may also need further transfusions during ongoing treatment, or during their bone marrow transplantation. Unfortunately, in cases where the AML is not controlled well or where the AML has recurred, patients may become more dependant on blood transfusions.
.

Depending on the patient’s status, patients may need blood transfusions weekly in severe cases.
.

Can you drink alcohol with acute myeloid leukaemia?

Drinking alcohol as a patient with acute myeloid leukaemia is not recommended. Alcohol can worsen the fatigue experienced from AML and AML medications. Additionally, alcohol can limit the bone marrow’s ability to produce blood cells and worsen the gastrointestinal effects of chemotherapy.
..

Can you gain weight with acute myeloid leukaemia?

Weight gain is uncommon with acute myeloid leukaemia. In the early phases of the condition, many patients may be asymptomatic. However, as AML progresses, most patients develop symptoms related to bone marrow suppression, and weight loss is a common feature as the AML progresses.
.

What lifestyle changes should AML patients make?

AML and the treatment related to AML will cause your immunity to weaken. As such, you will need to focus on your general well-being and diet.
.

Make sure you are well-rested but also maintain an active lifestyle as far as possible. Walks or simple exercise are encouraged. It is important that your family (or even close friends) are involved in supporting you, as the battle against AML is often stressful and tiring. It is important to have your family and friends available to support you on your treatment journey.
.

Our team of doctors and nurses at CFCH will advise you along every step of your AML treatment plan. In addition, we may recommend psychologists or dieticians to work with you as we develop a holistic treatment plan to provide you with the best support. 
.

A well-balanced diet can aid patients in coping with AML and its treatment. Patients may find that they are losing weight due to a loss of appetite as a side effect of some treatment options. Our doctors and nurses, together with dieticians, will offer you support on your diet. Some patients may be offered high-calorie, high-protein drinks to help regain their energy. 
..

Disclaimer:
The information on the Centre For Clinical Haematology website is intended for educational use.  It should not be considered or used as a substitute for medical advice, diagnosis or treatment from a qualified health professional.
.