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Acute Myeloid Leukemia: Treatment, Cost and Side Effects

Last Updated: Apr 25, 2024

What is the Acute Myeloid Leukemia?

Acute myeloid luekemia is a variety of blood cancer which affects the blood cells and bone marrow. This disorder is mainly characterised by rapid growth of immature white blood cells (leucocytes) which are known as leukemic blasts or myeloblasts. These cells cluster within the bone marrow and thus interfere with the production of normal blood cells. They even tend to ooze out into the blood stream and circulate within the body. Since these cells are immature, they do not possess the ability to fight infection or provide protection efficiently. Moreover, inadequate production of red blood cells and platelets by the bone marrow can lead to further complications such as anaemia, profuse bleeding and/or bruising. Acute myeloid leukemia may prove fatal if the patient is left untreated for a number of weeks.

The symptoms of acute myeloid leukemia include shortness of breath, irregular heartbeat, high risk of infection, fever, weight loss, headaches, fatigue, easy bruising and profuse bleeding. Certain factors like smoking, high doses of radiation therapy or chemotherapy, myelodysplastic syndrome, prolonged exposure to the chemical benzene may pose high risks in the question of developing acute myeloid leukemia. There is no effective way to prevent acute myeloid leukemia but avoiding smoking and over exposure to certain chemicals and radiation may reduce the risks of developing this syndrome. When a patient develops this syndrome, his/her normal bone marrow gets replaced with leukemic cells and this result in lowering of platelets, red blood cells and normal white blood cells.

The treatment for acute myeloid leukemia usually begins with diagnosis, which involves bone marrow aspiration and other specific blood tests. Acute myeloid leukemia is usually treated with chemotherapy, radiation therapy and/or a stem cell transplant. The time of survival as well as the therapy provided usually depends upon the specific genetic mutations that occur within the cancer cells.

How is the Acute Myeloid Leukemia treatment done?

The treatment for acute myeloid leukemia begins with proper diagnosis and they include bone marrow tests, blood test, lumbar puncture, gene tests and imaging tests (such as Xray imaging, computed tomography (CT) scans, ultrasound imaging). During a blood test, the patient’s complete blood count and peripheral smear is taken into account. Bone marrow test involves assessing a certain amount of bone marrow fluid from the thigh bone of the patient and observing it under a microscope. The patient may be diagnosed as having acute myeloid leukemia if 20% or more of his/her blood cells in bone marrow are immature. Lumbar puncture involves sampling a small amount of cerebrospinal fluid from the spinal cord and observing it under the microscope in order to make sure whether it contains leukemia cells. Gene tests involve cytogenetic analysis, immunophenotyping, fluorescent in-situ hybridization, polymerase chain reaction and others in order to look for changes within the genetic structure of the blood samples.

Due to its rapid progress, the treatment for acute myeloid leukemia should begin as soon as a patient is diagnosed as having this syndrome. The general method of treatment involves chemotherapy in order to destroy the leukemic cells and enhance remission. This treatment ensures that there no trace of leukemic cells in the blood and the bone marrow, and thereby the normal blood count and blood cell formation are restored. Once this is successfully achieved, more chemotherapy is given to the patient so as to prevent the leukemia from returning. Such a method is referred to as consolidation or post-remission therapy.

People having acute promyelocytic leukemia (a subtype of acute myeloid leukemia) may even be treated with a non-chemotherapy drug known as all-trans retinoic acid, a vitamin A derivative which acts on the leukemic cells by either making them properly mature or killing them (if the maturity cannot be achieved).

In addition to this, a stem cell transplant may also help to increase the chances of recovery for some patients having acute myeloid leukemia.

Who is eligible for the treatment? (When is the treatment done?)

Acute myeloid leukemia can occur at any age but it is more common among people above 60 years in age. In addition to this, it is more common among males than in females. Any person diagnosed as having acute myeloid leukemia should seek immediate treatment in order to avoid further complications since this syndrome shows rapid progress within a very short time and may even prove fatal.

Who is not eligible for the treatment?

Any person, having a normal and healthy blood count along with mature white blood cells and is diagnosed as not having acute myeloid leukemia, is not eligible for this treatment.

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Are there any side effects?

The treatment for acute myeloid leukemia have some side effects, whose severity vary among different patients, depending upon the treatment they are undergoing and how each one of them responds to it. It is important that these side effects should be brought to an immediate notice of the concerned doctor, since they can be treated effectively and are reversible. Some of the possible side effects of the treatment of acute myeloid leukemia using chemotherapy involve nausea, vomiting, weakness and fatigue, temporary loss of hair, rashes, mucositis, diarrhoea, constipation, fertility issues, skin problems and ulcers.

What are the post-treatment guidelines?

The treatment for acute myeloid leukemia may require months or even years for its completion. However, the patient still needs to go through several follow up examinations every few months for a number of years. The patient should attend all the follow up treatments as directed by his/her doctor and go for regular blood tests and bone marrow examinations. This should be done in order to check the possibilities of reoccurrence of cancer, as well as the probable side effects of such treatments. Almost all cancer treatments have their side effects and so it is important that the patient must inform his/her doctor regarding this issue and seek the necessary remedial measure.

How long does it take to recover?

Unfortunately, acute myeloid leukemia has no cure, but the symptoms can be managed using radiation therapy and chemotherapy. The lifespan of a patient after being diagnosed as having this syndrome, depends mainly upon the severity of the leukemia and the type of treatment that he/she is undergoing. On an average the treatment may take months or even years for its completion.

What is the price of the treatment in India?

The treatment of acute myeloid leukemia is very much costly and it varies in different parts of India. The average cost of treatment ranges between Rs. 1,82,54,954 to Rs. 3,53,78,807. This treatment is available in almost all leading hospitals in India.

Are the results of the treatment permanent?

The results of the treatment for acute myeloid leukemia are not permanent and there lies a chance for the syndrome to reoccur after a certain period of time. Since complete cure for this problem is not available, it is highly recommended that the patient should go for regular check-up and blood tests in order to check the progress of such a cancer.

What are the alternatives to the treatment?

There are no alternatives for the treatment of acute myeloid leukemia. Radiation therapy, chemotherapy and stem cell transplant are considered as the best methods of treatment for this syndrome.

References

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Written ByDr. Jagdish Shinde MD - Radiothrapy,MBBSOncology
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Reviewed ByDr. Bhupindera Jaswant SinghMD - Consultant PhysicianGeneral Physician
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