Acute Myelomonocytic Leukemia

What is Acute Myelomonocytic Leukemia?

Acute Myelomonocytic Leukemia is a common type of pediatric AML, which is acute myeloblastic leukemia. AML is a group of cancerous bone marrow neoplasms of myeloid precursors of white blood cells. Acute Myelomonocytic Leukemia is a rare condition that affects only about 3% of leukemia patients, and is more commonly referred to as AML-M4. Acute Myelomonocytic Leukemia occurs when 20 to 30% of the myeloblasts in the bone marrow aspirate, meaning that the bone marrow is being taken over by malignant cells.

Acute Myelomonocytic Leukemia Statistics

The incidence of Acute Myelomonocytic Leukemia is very rare, and only affects about 4 to 6 out of every one million children in the United States each year. There is no male or female preponderance, but certain ethnicities are more likely to develop AML-M4. Hispanics and Asians are at a higher risk, with Caucasians and Africans less likely than the before mentioned. Unfortunately, the outcome of Acute Myelomonocytic Leukemia is very poor, and only about 35 to 60% of those diagnosed survive after treatment.

Causes of Acute Myelomonocytic Leukemia

The exact cause of Acute Myelomonocytic Leukemia is left unknown, but there are many known factors that can lead children to the development of this specific leukemia. Many congenital and acquired diseases can predispose to AML-M4, including Down syndrome, blood syndrome, congenital neutropenia, and even Fanconi’s anemia. Many other factors that can lead to the development of Acute Myelomonocytic Leukemia include exposure to tobacco, marijuana, or alcohol prior to birth, pesticides and herbicides, Aplastic anemia, chemotherapy, and radiation therapy. Although many of these factors can contribute to the development of Acute Myelomonocytic Leukemia in young children, not all children will develop leukemia if exposed to any of the mentioned factors.

Symptoms of Acute Myelomonocytic Leukemia

Children with Acute Myelomonocytic Leukemia will normally show a variety of different symptoms, many of which are related to the Leukemia and many others that may be life-threatening conditions. The majority of AML-M4 patients will first feel the effects of fatigue, which is normally accompanied with a high fever. Because neutrophil is decreased by the leukemia, severe infections usually form if the disease is not spotted right away. Children may notice that they bruise very easy as well as bleed, and may even notice blood during a bowel movement. Symptoms similar to those seen with a basic cold or flu are usually present, including nausea, vomiting, and headaches, but are normally much more severe than a bug that is going around. Because Acute Myelomonocytic Leukemia typically affects infants and small children, it can sometimes be hard to determine what symptoms a child may be feeling.

Treatment Options for Acute Myelomonocytic Leukemia

Acute Myelomonocytic Leukemia is a very difficult disease to treat, and only about half of the diagnosed cases are fully healed. The treatment usually starts out with aggressive multi-drug chemotherapy regimens, including cytarabine, anthracyclins, and etopocide. Although this is one of the very few successful treatment options for Acute Myelomonocytic Leukemia, it brings along many risks and severe side effects. Some Acute Myelomonocytic Leukemia patients also benefit from bone marrow transplants, but finding donors with the same bone marrow can be very difficult. Bone marrow surgery is only considered when a patient is responding well to chemotherapy treatments, and the type and progression of the AML-M4 also determine whether or not surgery can be performed. Radiation therapy is sometimes applied in emergency situations in order to kill off remaining malignant cells, but chemotherapy is typically the treatment choice for patients with Acute Myelomonocytic Leukemia.

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