*Please note: This slide show represents a visual interpretation and is not intended to provide, nor substitute as, medical and/or clinical advice.
What is Acute Myeloid Leukemia (AML)?
Acute myeloid leukemia, or AML, is a cancer that starts in the bone marrow, the soft inner part of the bone where new blood cells are made.
What is AML?
Acute means the cancer usually comes on quickly and gets worse quickly if not treated.
Myeloid describes the abnormal white blood cells that build up in the bone marrow in AML. These cells are called myeloblasts.
Leukemia means that the cancer starts in the bone marrow's blood-forming cells.
How common is AML in children and teens?
AML is rare in children and teens. Each year, about 700 children and teens in the United States are diagnosed with AML.
AML occurs more often in children under age 2 and in teenagers. It affects boys and girls of all races about equally.
What happens in AML?
AML happens when the normal blood forming cells called myeloblasts become cancerous, forming leukemic myeloblasts.
These abnormal cells build up in the bone marrow, crowding out healthy blood cells.
Most often, AML starts in cells that would normally turn into white blood cells. It may also start in cells that would normally turn into red blood cells or platelets.
What happens in AML?
Normally, about 5% of blood cells in the bone marrow are immature blood cells called blasts. AML is diagnosed when blasts become cancerous and grow in number to 20% or more of blood cells in the bone marrow.
What happens in AML?
Abnormal blasts can spread into the bloodstream and to other parts of the body like the skin (where they may cause bruising), gums (where they may cause swelling and bleeding), and spinal fluid.
What causes AML?
Like other cancers, AML starts when certain genes in healthy cells become abnormal.
Genes play different roles in the body
Genes play different roles in the body. Some genes are involved in helping cells grow, divide, and stay alive. Others keep cells from growing and dividing too much.
What causes AML?
Genes can undergo changes, or mutations.
Some mutations may be present at birth. Others develop during your life.
Some mutations are harmless. Others can increase your risk for cancer or other diseases.
Several kinds of gene mutations can cause AML
Several kinds of gene changes can cause AML.
The most common change is a piece of one chromosome breaking off and getting attached to another chromosome.
Or a piece of a chromosome may be missing.
Or there may be an extra chromosome that shouldn't be there.
What causes AML?
Understanding what genes are changed in AML helps doctors choose treatments and predict the patient's outlook.
Recent studies have shown that the genetic changes seen in children and teens with AML are very different from those seen in adults with AML.
This knowledge may help find new and better treatments for AML in children and teens in the future.
What are the symptoms of AML?
Symptoms of AML in children may include:
Fever,
Feeling tired,
Feeling cold,
Headaches,
Losing weight,
Losing appetite,
Bruising or bleeding easily,
Bone or joint pain,
Skin rash, and
Bleeding gums,
Or even no symptoms at all
Are some children and adolescents at higher risk for AML?
Children and teens have a higher risk for AML if they:
Are born with certain genetic mutations,
Have a brother or sister – especially a twin – who had leukemia, or
Are born with certain diseases that lead to a failure of the bone marrow to function normally.
About AML subtypes
Doctors classify subtypes of AML by:
The kind of bone marrow cell that the cancer cells develop from,
The kind of abnormal genetic features the cancer cells have,
Whether the patient has Down syndrome, and
Whether the patient had a previous cancer that was treated with radiation or chemotherapy.
Some terms you’ll hear your doctor use
Here are some terms your doctor may use when talking about AML:
De novo: When cancer occurs for the first time.
Myelosuppression: Too few healthy blood cells in the bone marrow.
Anemia: Too few healthy red blood cells in the body.
Some terms you’ll hear your doctor use
Complete remission: Less than 5% of cells in the bone marrow are abnormal blasts. All blood cell counts are in the normal range. No signs or symptoms of AML.
Molecular complete remission: Even highly sensitive lab tests can't detect any cancer cells in the bone marrow.
Minimal residual disease, or MRD: Cancer cells left after treatment that can only be detected with highly sensitive lab tests. This is also called measurable residual disease.
Some terms you’ll hear your doctor use
Relapse: When AML comes back after it's been treated.
Resistant disease: When treatment for AML doesn't work. This is also called refractory disease.
More questions about AML in children and adolescents?
You may have more questions about what a diagnosis of AML means for your child or teen.
Ask your doctor for a referral to a pediatric hematologist. These doctors specialize in treating blood cancers in children and adolescents. And they work with a team of nurses and others who:
Can answer your questions, and
Talk with you about the best way forward for your child or teen with AML.
References
American Cancer Society. Childhood Leukemia Subtypes. Last revised: February 12, 2019. https://www.cancer.org/cancer/leukemia-in-children/detection-diagnosis-staging/how-classified.html
American Cancer Society. Key Statistics for Childhood Leukemia. Last Revised: January 12, 2021. https://www.cancer.org/cancer/leukemia-in-children/about/key-statistics.html
American Cancer Society. Leukemia - Acute Myeloid - AML - Childhood: Statistics. https://www.cancer.net/cancer-types/leukemia-acute-myeloid-aml-childhood
American Cancer Society. What is Childhood Leukemia? Last revised: February 12, 2019. https://www.cancer.org/cancer/leukemia-in-children/about/what-is-childhood-leukemia.html
American Cancer Society. Prognostic Factors in Childhood Leukemia (ALL or AML). Last Revised: February 12, 2019. https://www.cancer.org/cancer/leukemia-in-children/detection-diagnosis-staging/prognostic-factors.html
American Cancer Society. Risk Factors for Childhood Leukemia. Last Revised: June 9, 2020. https://www.cancer.org/cancer/leukemia-in-children/causes-risks-prevention/risk-factors.html
American Society for Clinical Oncology. Cancer.Net Guide to Leukemia – Acute Myeloid – AML – Childhood. https://www.cancer.net/cancer-types/leukemia-acute-myeloid-aml-childhood
Chaudhury S et al. Age-specific biological and molecular profiling distinguishes paediatric from adult acute myeloid leukaemias. Nature Communications. 2018;9:5280. https://doi.org/10.1038/s41467-018-07584-1
Leukemia & Lymphoma Society. Acute Myeloid Leukemia in Children and Teens. 2021. https://www.lls.org/booklet/acute-myeloid-leukemia-children-and-teens
MedlinePlus. What is a gene? https://medlineplus.gov/genetics/understanding/basics/gene/
National Cancer Institute. Childhood Acute Myeloid Leukemia/Other Myeloid Malignancies Treatment (PDQ®)–Patient Version. Updated: August 17, 2021. https://www.cancer.gov/types/leukemia/patient/child-aml-treatment-pdq
National Cancer Institute. TARGET Study Finds Major Differences between Childhood and Adult AML. 2018 Jan 30. https://www.cancer.gov/news-events/cancer-currents-blog/2018/genetic-differences-childhood-adult-aml
Slide Show - Understanding AML in Children and Adolescents
This slide show provides an overview of acute myeloid leukemia (AML) in children and adolescents (also known as pediatric AML). You can learn about the causes, risk factors, symptoms,and subtypes of AML in children and teens, as well as some of the terminology you will hear your doctor use.
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