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Acute Nonlymphocytic Leukemia

Alternate Names

  • acute myelogenous leukemia
  • AML

Definition

Acute nonlymphocytic leukemia (ANLL) is a kind of cancer that occurs in a specialized white blood cell called a myelocyte. The cancerous change usually occurs in the bone marrow, where blood cells are made. The cancer cells grow and often take over the bone marrow. They can also travel throughout the body, a process known as metastasis. The cancerous cells can then interfere with the normal function of many parts of the body.

What is going on in the body?

When the cancerous cells grow in the bone marrow, normal bloods cells are often destroyed or crowded out. A reduction in normal white cells can cause the person to become infected easily. The infections may be serious and life threatening. Fewer platelets means that the person may bruise or bleed easily. Anemia, or low numbers of red blood cells, can make the person weak and easily tired.
The cancerous white cells can multiply quickly. Then, some of them can leave the bone marrow and travel throughout the body in the bloodstream. This often leads to problems in other parts of the body.

Risks

What are the causes and risks of the disease?

ANLL is thought to have many causes, including:
  • certain chemicals, such as benzene and toluene
  • certain genetic defects, such as Down syndrome
  • cigarette smoke
  • exposure to large doses of radiation
  • some unusual viruses
Very rarely, people who have been given certain types of chemotherapy later develop ANLL.

Prevention

What can be done to prevent the disease?

In most cases, nothing can be done to prevent ANLL. Exposure to chemotherapy and radiation should be limited, when possible. Chemicals such as benzene and toluene should also be avoided. Someone who smokes should quit smoking.

Diagnosed

How is the disease diagnosed?

Diagnosis of ANLL begins with a medical history and physical exam. A blood sample is examined to see if it contains cancerous white cells. Also, the blood sample can be used for special genetic testing. A bone marrow biopsy can confirm that the person has ANLL.

Long Term Effects

What are the long-term effects of the disease?

ANLL can quickly lead to death if it is not treated. If the treatment is effective, the person will recover and live a normal life.

Other Risks

What are the risks to others?

ANLL is not contagious and poses no risk to others.

Treatments

What are the treatments for the disease?

ANLL is usually treated with chemotherapy. This involves a combination of powerful medicines given through the veins. These medicines are usually given over several months. Chemotherapy will kill the ANLL cells, but it will also damage the normal bone marrow. Some people are given bone marrow from another person to help recovery. This is called a bone marrow transplant.
The first course of therapy is called induction therapy. It is designed to induce a remission, or complete destruction of the ANLL. After remission, the original treatment is repeated. This is to make the remission last by destroying any remaining disease.

Side Effects

What are the side effects of the treatments?

Side effects of treatments can include some of the same signs and symptoms as the leukemia, such as:
  • allergic reactions to medicines
  • bleeding problems that may require transfusions
  • common or unusual infections
  • diarrhea or poor food absorption
  • irritation of the gastrointestinal tract
  • mouth sores
  • nausea and vomiting
  • numbness or burning pain in the extremities
  • weakness and fatigue
  • weight loss
The person will experience other specific side effects related to the type of medicine that is given.

After Treatment

What happens after treatment for the disease?

After therapy has been completed, the bone marrow will usually recover and begin to function normally again. This usually takes several weeks. A cycle of treatment followed by a recovery period may be repeated several times until all signs of ANLL are gone.

Monitor

How is the disease monitored?

After all therapy has been completed, blood samples will be taken to make sure the person continues to be in remission. Another bone marrow biopsy may also be needed. Any new or worsening symptoms should be reported to the healthcare provider.

Sources

Khouri, I, Sanchez, F.G., Deisseroth, A.(1997). Leukemias in Cancer: Principles and Practice of Oncology. 5th Edition DeVita, V.T. (ed). J.B. Lippincott: Philadelphia. Pp. 2287-2321.

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