Acute myeloid leukemia

Acute myeloid leukemia overview

Acute myeloid leukemia (AML) is a cancer of the bone marrow and blood. It is also called acute myelogenous leukemia or acute myelocytic leukemia. It happens when some of your blood stem cells stop working normally. They start making immature myeloid cells, also called blasts, that turn into cancer.

Fred Hutchinson Cancer Center provides all standard therapies for AML. Our experts are national leaders in AML research and have developed many of these approaches.

Many of our AML patients join clinical trials — led by world-class physicians from Fred Hutch and UW Medicine — to be able to try the newest therapies that are not available anywhere else.

Bone marrow The soft, spongy material in the center of your bones that produces all your blood cells, such as white blood cells, red blood cells and platelets. Standard care A treatment or other intervention currently being used and considered to be of proven effectiveness based on past studies. Stem cell A cell from which other types of cells develop. For example, blood cells develop from blood-forming stem cells.

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Fred Hutch: A Leader in AML Treatment

Care for AML is very complex. More than two dozen medicines are already approved to treat this disease, and many new options are being developed. Getting the medicines that are right for you means everything. This is why it is important to come to a center, like Fred Hutch, that has deep experience in this disease. Our long history of caring for people with AML means the best care for you.

Confirming your AML diagnosis

Diagnosing AML involves a series of blood tests and sometimes a bone marrow aspiration and biopsy. These show if you have cancer, and they give your physicians details about the cancer type and subtype.

Most of our patients begin AML treatment by going straight to the inpatient hospital at UW Medical Center - Montlake. There, they quickly receive chemotherapy. Some people come to the South Lake Union Clinic first and then go to the hospital for care.

Either way, our experts will check and confirm your leukemia type and subtype. We also look for features of your AML that matter in planning your personalized treatment.

Hematopathologists are lab experts who look at samples of your blood and bone marrow with a microscope. They can tell which subtype you have by carefully studying these tissues. At Fred Hutch and UW Medical Center, our hematopathologists are very experienced in identifying AML.

Biopsy The removal of a sample of tissue or fluid that is examined to see whether cancer is present. This may be done with a large needle or through surgical removal of tissue or fluids. Bone marrow The soft, spongy material in the center of your bones that produces all your blood cells, such as white blood cells, red blood cells and platelets. Chemotherapy Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. It may be given alone or with other treatments. Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy may be given by mouth, injection, infusion or on the skin, depending on the type and stage of the cancer being treated. It may be given alone or with other treatments, such as surgery, radiation therapy or biologic therapy.

Confirming your AML diagnosis

To provide the right treatment for you, we will begin by checking details about your disease.

Subtypes and risk groups for AML

Different subtypes of AML affect you in different ways. They respond differently to treatments, too. Some are harder or easier to treat. Some are more or less likely to come back.

Your subtype is based mainly on three factors:

How mature your cancer cells are
How similar they are to normal cells
If they have certain changes in chromosomes or genes

We get these details from your biopsy.

AML subtypes are:

AML with recurrent genetic abnormalities: This subtype has many subgroups. It includes acute promyelocytic leukemia (APL), an aggressive AML subtype that is treated differently from other subtypes.
AML with myelodysplasia-related changes
Therapy-related myeloid neoplasms
Myeloid sarcoma
Myeloid proliferation related to Down syndrome
AML, not otherwise specified: This subtype has many subgroups.

Along with subtype, your physicians will look at gene changes in your cancer cells to put your AML in a risk group: “favorable,” “intermediate” or “poor or adverse.” This tells us more about the best ways to treat your disease.

Fred Hutch physicians treat all AML subtypes and risk groups.

Biopsy The removal of a sample of tissue or fluid that is examined to see whether cancer is present. This may be done with a large needle or through surgical removal of tissue or fluids. Chromosome Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. Gene The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein.

Subtypes and risk groups for AML

Your subtype and risk group help your physicians predict the outlook for your disease. They also help us design a treatment plan for you with the greatest chance for success.

Your first appointment

If you have been diagnosed with AML, Fred Hutch is here for you. Your first appointment at the South Lake Union Clinic may happen either before or after you go to the hospital for your initial chemotherapy.

From the first time you come to see us, your clinic team will begin getting to know you and your family. What are your questions? What are your concerns?

We will also explain your specific disease and your treatment options. Before you leave, your team makes sure you understand the next steps.

AML First Appointment

Care at Fred Hutch

How do we approach treatment?

The safest, most effective and most widely accepted therapies for cancer are known as the “standard of care.” For many patients, these therapies will be a large part of their treatment. At Fred Hutch, we provide all standard therapies for AML. We know how to choose the right ones for you and how to deliver them to give you the best chance at a full recovery.

Our physicians and researchers are always asking how we can make AML treatments more effective and reduce side effects as much as possible. This is why we do clinical trials (also called clinical studies). Through these studies, we are able to offer you therapies that aren’t available everywhere. A therapy that is going through trials today may become the new standard of care tomorrow.

Along with treating your cancer, a group of world-class professionals is here to support you. This team includes advanced practice providers, pharmacists, nurses, dietitians, physical therapists, social workers and psychologists. We also include supportive care services for your physical, mental and emotional well-being.

Clinical trial A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis or treatment of a disease. Side effects A problem that occurs when treatment affects healthy tissues or organs. Some side effects of cancer treatment are nausea, vomiting, fatigue, pain, decreased blood cell counts, hair loss and mouth sores. Standard care A treatment or other intervention currently being used and considered to be of proven effectiveness based on past studies. Standard care A treatment or other intervention currently being used and considered to be of proven effectiveness based on past studies.

Treatment plan and process

You are unique, and your care team will design a treatment plan specifically for — and with — you. At Fred Hutch, physicians with knowledge and experience in AML will plan and provide your care.

The first phase of treatment is meant to put the disease in remission. The next phase is to clear any AML cells that remain. Usually, the main form of treatment is chemotherapy. Some people also get targeted therapy or immunotherapy. Others have a blood or marrow transplant. We combine treatments to fit your exact case.

As you go through treatment, your needs may change. Your care team at Fred Hutch is with you each step of the way. For example, we will help you deal with any side effects you have. We may suggest adding a new therapy that was just approved. Even after your AML treatment is done, we will keep seeing you to protect your health over the long term.

Chemotherapy Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. It may be given alone or with other treatments. Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy may be given by mouth, injection, infusion or on the skin, depending on the type and stage of the cancer being treated. It may be given alone or with other treatments, such as surgery, radiation therapy or biologic therapy. Immunotherapy A type of therapy that uses substances to stimulate or suppress the immune system to help the body fight cancer, infection and other diseases. A therapy that uses substances to stimulate or suppress the immune system to help the body fight cancer, infection and other diseases. Some immunotherapies only target certain cells of the immune system. Others affect the immune system in a general way. Types of immunotherapy include cytokines, vaccines, bacillus Calmette-Guerin (BCG) and some monoclonal antibodies. Remission A decrease in, or disappearance of, signs and symptoms of cancer. A decrease in, or disappearance of, signs and symptoms of cancer. In partial remission, some (but not all) signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although cancer still may be in the body. Side effects A problem that occurs when treatment affects healthy tissues or organs. Some side effects of cancer treatment are nausea, vomiting, fatigue, pain, decreased blood cell counts, hair loss and mouth sores. Targeted therapy A type of treatment that uses drugs or other substances to identify and attack specific types of cancer cells while causing less harm to normal cells. A type of treatment that uses drugs or other substances to identify and attack specific types of cancer cells while causing less harm to normal cells. Some targeted therapies block the action of certain enzymes, proteins or other molecules involved in the growth and spread of cancer cells. Other types of targeted therapies help the immune system kill cancer cells, or they deliver toxic substances directly to cancer cells and kill them. Targeted therapy may have fewer side effects than other types of cancer treatment. Most targeted therapies are either small molecule drugs or monoclonal antibodies. Treatment plan A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A treatment plan may also include information about how much the treatment is likely to cost and about regular follow-up care after treatment ends.

Treatment for AML

For caregivers

When someone close to you is diagnosed with AML, you might step into the role of caregiver. Being a caregiver can mean many things, from lending a hand with daily living tasks to helping with medical decisions. It can also mean dealing with your own emotions and stress.

At Fred Hutch, caregivers are valuable members of a patient’s care team. We see every day that your presence and support make a difference. We know that what your friend or family member is going through affects you, too.

Part of our mission is to help you take care of yourself. Caring for yourself is good for your physical, mental and emotional health. It also helps you give your best to your loved one. Our social workers, Spiritual Health team and Patient and Family Resource Center staff are here to help support you.

Caregiver A person who gives care to people who need help, such as children, older people or patients who have chronic illnesses or disabilities. A person who gives care to people who need help taking care of themselves, such as children, older people or patients who have chronic illnesses or disabilities. Caregivers may be health professionals, family members, friends, social workers or members of the clergy. They may give care at home, in a hospital or in another health care setting.

For Caregivers

Resources for Caregivers

Other resources

Care team

At Fred Hutch, a team of dedicated people surrounds you and your family to give you the highest level of care and support. You are the most important person on your care team. Our patients are at the center of everything we do.

AML Care Team

Care team

Research

Fred Hutch is a national leader in AML research. Our scientists and physicians are working all the time to improve current treatments for AML and develop new ones so every person with this disease lives a long, healthy life.

AML Research

Research

Hematologic Malignancy Genetics Clinic

If you might be at higher risk for blood cancer because of your genes, we have a special clinic for you. The Hematologic Malignancy Genetics Clinic is here to assess your risk. We also provide care to help lower your risk going forward. Fred Hutch is one of only a few cancer centers in the nation with a clinic like this.

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Hematologic Malignancy Genetics Clinic

Resources

There are many resources for learning about your disease, as well as organizations that provide support. Health educators at the Fred Hutch Patient and Family Resource Center have put together a list of trusted sources to help you get started.

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Resources

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