Acute Myeloid Leukemia (AML)

Background of Acute Myeloid Leukemia (AML)

Acute myeloid leukemia (AML), also known as acute myelogenous or acute myeloblastic leukemia, is a type of cancer that starts from cells that normally develop into blood cells. AML mainly develops from two types of white blood cells: granulocytes or monocytes. AML is caused by genetic damage to these developing cells in the bone marrow. The result is uncontrolled growth and accumulation of undeveloped cells called "leukemic blasts," which fail to function as normal blood cells. As these cells accumulate, they block the production of normal marrow cells, leading to a deficiency of red cells, blood-clotting platelets and normal infection-fighting white cells.

Acute myelogenous leukemia (AML) is the most common form of leukemia with more than 13,000 people diagnosed each year, according to National Cancer Institute estimates. About 15 percent of childhood leukemia cases are AML. Older individuals, however, are more likely to develop the disease. The median age at diagnosis is 67. Of those with AML, less than 6 percent are younger than 20 when diagnosed; more than 55 percent are diagnosed at 65 or older. About 0.38 percent of people will be diagnosed with AML during their lifetimes. The cause of AML is unknown. It is not contagious and is not inherited, but several factors have been linked to increased risk of the disease. These include exposure to very high doses of radiation, exposure to the chemical benzene and exposure to chemotherapy. Smoking is another proven risk factor, which causes about 1 in 5 cases of AML. Uncommon genetic disorders, such as Fanconi anemia and Down syndrome, are associated with an increased risk of AML.

Hutchinson Center Acute Myeloid Leukemia Research

Overview of Hutchinson Center AML Research

The Hutchinson Center is recognized as one of the leading centers involved in the research and treatment for acute myeloid leukemia (AML). The center pioneered bone-marrow transplantation (BMT) and has trained doctors from around the world in bone-marrow and stem-cell transplantation. Today, transplantation remains one of the most effective treatments for most types of leukemia. Through clinical trials at the Seattle Cancer Care Alliance, AML patients have access to the most promising treatments available.

Research topics

• Development of more effective transplant regimens with fewer toxic side effects, including the nonmyeloablative or "mini" transplant.
• Development of targeted therapies such as monoclonal antibodies used to deliver chemotherapy or radiation to cancer cells, sparing healthy cells from damage.
• Understanding the biology of blood and bone-marrow function, and the genetic origins of blood cancers like leukemia, which may shed new light on genes involved in acute myeloid leukemia (AML) progression and ultimately could lead to new drugs or other therapies that target defects in these genes.
• Discovering the delayed effects of the transplant preparative regimens and developing methods to treat these effects to minimize the toxicity on the patients. This is especially important for children who have to complete their physical growth and development after the transplant.
• Understanding why older AML patients have a poorer prognosis than younger patients, including increased likelihood of drug resistance to chemotherapy.

Recent accomplishments

• Pioneering the mini-transplant, a modified blood stem-cell transplant procedure that involves minimal total body irradiation and a stem-cell infusion; results in very few acute side effects, making the procedure much more tolerable for both younger and older patients; and often involves no hospitalization.
• Detecting the earliest signs of relapse, or minimal residual disease, in a subset of ALL patients whose cancer cells contain a certain type of genetic defect. Using a highly sensitive test developed at the Hutchinson Center that can detect one in a million cancer cells, doctors can swiftly initiate new treatment in patients whose disease is recurring after initial therapy.
• Finding that some children with an aggressive form of leukemia whose cancer returns after a stem-cell transplant can be cured with a second transplant. In a study of 25 children with acute myeloid leukemia who relapsed after a first transplant, Hutchinson Center researchers found that nearly half of those who underwent a second transplant from a tissue-matched donor were still alive after 10 years.
• Pioneering the concept of linking a chemotherapy drug to an antibody, which led to the development of Mylotarg®: the first FDA-approved, antibody-targeted chemotherapy. The drug is a less toxic and more effective form of cancer treatment than standard chemotherapy.

Articles Related to Acute Myeloid (Myelogenous) Leukemia (AML)

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