Acute Myeloid Leukemia
Acute Myeloid Leukemia (AML) is a type of blood cancer that starts in the bone marrow, the spongy tissue inside our bones, where blood cells are made. In AML, immature blood cells called myeloid blasts don’t grow into healthy blood cells. Instead, they build up in the bone marrow and blood, crowding out normal red blood cells, white blood cells, and platelets. This makes it harder for your blood to do important jobs like carrying oxygen, fighting infections, and stopping bleeding.
AML is one of the most common types of leukemia in adults. It can grow quickly, so it needs treatment right away.
At Johns Hopkins, our team of experts specializes in AML. We use the latest treatments and work together to give you the best care possible.
Different Types of AML
AML is not the same for everyone. Doctors often study the changes to the genes within your leukemia cells to better understand your disease. Certain genetic changes can provide important clues about your AML and help guide your treatment plan.
For example, some genetic changes can make leukemia harder to treat with certain medicines, but not others. Sometimes, there are special medicines made to work with specific genetic changes.
Clinical Trials
Clinical trials offer access to medical treatments that are being tested on AML, such as new chemotherapy drugs or immunotherapy, which may work better for you than a standard course of treatment. Johns Hopkins is a leading research institution offering trials that test the latest therapies and technologies. Johns Hopkins may also connect you with trials being conducted by cooperating organizations or by industry. Ask your treatment team about clinical trials early on.
Treatment
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Chemotherapy is the main treatment for AML. It uses strong medicines to kill fast-growing cells, including cancer cells. Some chemotherapy medicines, like cytarabine and daunorubicin, work by stopping cancer cells from growing and dividing. Others, called hypomethylating agents (such as azacitidine and decitabine), help “wake up” genes that fight cancer.
Chemotherapy can have side effects, like nausea, fatigue, and hair loss. It’s important to talk to your care team about how you’re feeling so they can help manage these effects.
Chemotherapy is usually given in cycles, with breaks in between to let your body recover. Your care team will explain your treatment plan, including what medicines you'll get and whether you’ll need to stay in the hospital.
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Targeted therapy uses medicines that attack specific parts of cancer cells without harming normal cells. The choice of targeted therapy often depends on the genetic changes in your leukemia cells. For example:
- BCL2 inhibitors (Venetoclax) are used in combination with hypomethylating agents for patients who are older or who have other medical conditions that may make them sensitive to the side effects of chemotherapy.
- FLT3 inhibitors work for patients whose leukemias have mutations in the FLT3 gene.
- IDH inhibitors work for patients whose leukemias have mutations in the IDH1 or IDH2 genes.
- Gemtuzumabozogamicin attaches to a specific protein found on leukemia cells and delivers chemotherapy directly to them.
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A bone marrow transplant, also called a stem cell transplant, may be needed if leukemia cells are still present after chemotherapy. This treatment provides the patient witha new immune system that has the capacity to recognize the remaining cancer cells as “foreign” and to eliminate them from the body.