By Dr. Biju George: Cancer is one of the greatest healthcare challenges the world currently faces. When it comes to cancer, it is not just the lack of well-equipped facilities that hampers timely detection and care. The lack of adequate awareness has also led to a rise in the number of deaths due to the disease worldwide. The complexity of the disease and the sheer burden often result in poor outcomes. One such aggressive blood cancer is acute myeloid leukaemia (AML), which is often overlooked.
The global incidence of AML has risen from over 9,000 in 1990 to nearly 1.5 lakh cases in 2021 with deaths rising from over 74,000 to 1.3 lakhs in the same period. Given the alarming statistics, it is necessary to create awareness about this disease and take steps to reduce its burden.
What Is Acute Myeloid Leukaemia, Or AML?
AML is a cancer of the blood and the bone marrow. The bone marrow contains myeloid cells that convert into different cells with multiple functions such as:
- Red blood cells which transport oxygen
- Platelets that control bleeding
- White blood cells which fight off infections
The exact cause of the disease is not known but it develops due to genetic changes in bone marrow cells (myeloid cells). In patients with AML, the myeloid cells start multiplying rapidly due to DNA modifications. The rapid production also results in the formation of immature or abnormal cells called blasts that cannot function properly. Their sheer number crowd out the healthy cells in the bone marrow. This leads to a lack of adequate oxygen supply or vulnerability to infections.
The common symptoms include:
- Easy bruising
- Recurrent infections
- Bone pain
- Weakness
- Anaemia
- Shortness of breath
The risk factors include a history of chemotherapy, radiation and benzene exposure, and tobacco smoke. In many cases, patients may present without any known risk factors.
In India, leukaemia (blood cancer) has an incidence rate of 49,883. The prevalence of AML in 2019 was an average of 27.9% in men and women. AML accounted for more than 10.5% of the total number of leukaemia cases.
Here are three key facts about AML everyone should know:
3 Key Facts About AML
1. AML can occur in people of all ages: AML is the most common form of leukaemia among adults and the median age of diagnosis is between 66 and 71 years. However, as per a study, in India, adults are affected nearly 20 years earlier, with the median age of diagnosis being 40 years. Additionally, AML accounts for nearly 15 to 20% of all leukaemia cases in children.
2. AML is treatable: Between 60 and 70% of adult patients (18-65 years) can achieve complete remission with the right kind of treatment. However, the five-year survival rate is 31.7%. Today, AML can be treated in several ways using targeted therapy, chemotherapy, or through a bone marrow transplant. There are newer drugs that have shown remarkable progress when used along with other therapies in those ineligible for intensive chemotherapy.
3. Intensive chemotherapy is not for all patients with AML: Intensive chemotherapy is usually the first choice of treatment for patients. However, more than half of the newly diagnosed patients are ineligible for this treatment due to the subtype of AML, poor health, or old age. For many of these patients, other agents including novel agents are used to improve patient outcomes.
Being diagnosed with AML can be a devastating blow for individuals. However, as understanding of the disease grows alongside the inception of newer transformative treatment methods, patients and caregivers must be aware of these developments to enhance treatment outcomes and survival. By learning key facts about the disease, they can make informed decisions. The journey may be long and precarious, but with accurate and authentic information, patients can confidently navigate these complexities.
Dr. Biju George is Professor, Department of Haematology, at Christian Medical College, Vellore.
[Disclaimer: The information provided in the article, including treatment suggestions shared by doctors, is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition.]
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