Acute Myeloid Leukemia

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Acute Myeloid Leukemia

• Pamela Owen
• Based on a research paper for Genetics.

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My Motivation!!!

• Genetics
• One of the requirements of Genetics was a paper
  on a genetic disorder or disease.
• My Uncle
• Was diagnosed in January 97 with Acute Myeloid
  Leukemia. He is now in remission!!!

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Acute Myeloid Leukemia

• What is it?
• Subtypes
• Causation
• Symptoms
• Treatment
• After remission

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What is it?

• Leukemia
• Acute Leukemia
• Acute Myeloid Leukemia

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What is it?

• Leukemia
• A type of cancer characterized by the production
  of large numbers of immature, abnormal blood
  cells that look and act differently from normal
  blood cells.

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What is it?

• Acute Leukemia
• Rapidly progressing form that affects unformed or
  primitive cells

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What is it?

• Acute Myeloid Leukemia
• A rapidly progressing form of leukemia that
  originates in the bone marrow
• Involves the proliferation of non-functional
  white blood cells

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Subtypes

• Subtypes are categorized by the dominant leukemic
  cell type at the time of diagnosis
• The 7 subtypes are shown on the following chart

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Subtypes

• Designation Cell Subtype
• M1 Myeloblastic w/o
  maturation
• M2 Myeloblastic
  w/ maturation
• M3
  Promyelocytic
• M4
  Myelomonocytic
• M5
  Monocytic
• M6
  Erythroleukemia
• M7
  Megakaryocytic

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Causation

• Genetics of the disease
• Genetic risk factors
• Environmental risk factors

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Causation

• Genetic changes in AML
• Chromosomal changes lead to activation of
  oncogenes
• Translocation between chromosomes 8 and 12
• Translocation between chromosomes 15 and 17
• Deletion of a segment of chromosome 5 or 7

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Causation

• Genetic factors that predispose an individual to
  AML
• Fanconis anemia
• Down syndrome
• Blooms syndrome

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Causation

• Environmental factors known to cause AML
• Exposure to ionizing radiation
• Exposure to benzene
• Treatment with alkylating agents or procarbazine
• Treatment with other drugs
• Viral oncogenesis (speculative)

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Symptoms

• Warning signs
• What to expect after diagnosis

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Symptoms

• Warning signs
• Fatigue
• Prolonged bleeding
• Easy bruising
• Fever
• Frequent minor infections
• Joint pain

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Symptoms

• Possible side effects of treatment
• Hair loss (alopecia)
• Inflammation of the mouth (stomatitis)
• Difficulty swallowing (dysphagia)
• Nausea and vomiting
• Constipation
• Diarrhea
• Various skin reactions

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Treatments

• Goal of treatment Remission
• Chemotherapy
• Bone marrow transplants
• Radiation treatment

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Treatment

• Goal of treatment Remission
• Blood cell counts return to normal
• Leukemic cells can no longer be found in blood or
  marrow

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Treatments

• Chemotherapy
• Induction therapy
• Post-remission therapy

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Treatments

• Chemotherapy
• Induction therapy
• Initial stage of therapy to eradicate systemic
  and marrow-localized leukemic cells leading to
  remission
• Combination of an anthrocycline antibiotic and a
  cytarabine
• Both prevent DNA synthesis thus stopping growth
  and leading to their death
• If remission is not achieved with the first round
  of induction therapy, another round is begun

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Treatments

• Post-remission therapy
• Consolidation therapy
• Goal is to destroy any undetectable leukemic
  cells
• Many different approaches all of which involve
  short doses of intensive therapy
• Maintenance therapy
• months to years of less intensive therapy to
  prevent further recurrence

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Treatments

• Bone marrow transplant
• Used as a last resort if 3 rounds of induction
  therapy have been unsuccessful
• Used as or along with post-remission therapy
• Two types of transplants are used
• Autologous
• Allogeneic

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Treatments

• Radiation therapy
• Only used in rare cases where leukemic cells are
  centralized in one part of the body

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After remission

• If at any time after remission is achieved a
  relapse occurs the initial treatment may be
  repeated usually with minor changes in protocol
• If after five years of remission there have been
  no new outbreaks of leukemic cells the patient is
  considered cured

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Acknowledgements

• Dr. Newman
• Dr. Gabriel
• Dr. Angstadt