Acute Myelogenous Leukemia
Acute Myelogenous Leukemia
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Frequently Asked Questions (FAQ) :
The chemotherapy regimen often includes an induction phase to achieve remission and a consolidation phase to eliminate remaining leukemia cells. Common drugs include cytarabine and anthracyclines like daunorubicin or idarubicin.
Induction therapy aims to induce remission by killing as many leukemia cells as possible. This typically involves intensive chemotherapy.
Consolidation therapy, also known as post-remission therapy, involves additional chemotherapy or a stem cell transplant to eliminate any residual leukemia cells and prevent relapse.
Genetic mutations in AML can influence prognosis and treatment decisions. Mutations in genes like FLT3, NPM1, and IDH1/2 are commonly tested.
Targeted therapies block specific pathways or proteins involved in leukemia cell growth. Examples include FLT3 inhibitors (e.g., midostaurin), IDH inhibitors (e.g., enasidenib), and BCL-2 inhibitors (e.g., venetoclax).
What is Acute Myelogenous Leukemia :
Acute Myelogenous Leukemia (AML) is a fast-growing cancer of the blood and bone marrow. It affects the myeloid cells, which are responsible for producing red blood cells, white blood cells, and platelets. In AML, the bone marrow produces abnormal myeloblasts (a type of white blood cell), red blood cells, or platelets. These abnormal cells can crowd out normal cells, leading to anemia, infection, or bleeding problems.
Causes of AML
The exact cause of AML is not always clear, but several risk factors and genetic mutations have been identified that can increase the likelihood of developing this disease:
- 1. Genetic Mutations: Specific mutations in genes such as FLT3, NPM1, and IDH1/2 can lead to the development of AML. These mutations affect the regulation and proliferation of blood cells.
- 2. Previous Cancer Treatments: Chemotherapy and radiation therapy for other cancers can increase the risk of developing therapy-related AML.
- 3. Exposure to Chemicals: Long-term exposure to certain chemicals, such as benzene, can increase the risk.
- 4. Genetic Disorders: Conditions like Down syndrome, Bloom syndrome, and Fanconi anemia are associated with a higher risk of AML.
- 5. Myelodysplastic Syndromes: These are a group of disorders caused by poorly formed or dysfunctional blood cells, which can sometimes progress to AML.
Types of AML :
There are several subtypes of AML, each with distinct characteristics and treatment implications:
- 1. Acute Promyelocytic Leukemia (APL): A subtype characterized by the accumulation of promyelocytes. It is associated with a specific chromosomal translocation (t(15;17)).
- 2. AML with Myelodysplasia-related Changes: Occurs after myelodysplastic syndromes and is often associated with genetic abnormalities.
- 3. Therapy-related AML: Develops as a result of chemotherapy or radiation therapy for another cancer.
- 4. AML with Genetic Mutations: Subtypes classified based on specific genetic mutations, such as those in FLT3, NPM1, or IDH1/2.
Symptoms of AML :
The symptoms of AML are often non-specific and can be mistaken for other common illnesses. They include:
- Easy Bruising or Bleeding: Due to a low platelet count.
- Fever: Often a sign of infection.
- Shortness of Breath: Caused by anemia or an enlarged spleen.
- Pale Skin: Resulting from anemia.
- Unexplained Weight Loss: Often associated with cancer.
- Bone or Joint Pain: Caused by the buildup of abnormal cells in the bone marrow.
Diagnosis of AML :
Diagnosing AML typically involves several tests and procedures:
- 1. Blood Tests: To check for abnormal levels of white blood cells, red blood cells, and platelets.
- 2. Bone Marrow Aspiration and Biopsy: To examine the bone marrow cells for abnormalities.
- 3. Cytogenetic Analysis: To look for genetic changes in the leukemia cells.
- 4. Molecular Testing: To identify specific mutations in the leukemia cells.
Treatment Options for AML :
Treatment for AML is complex and depends on several factors, including the subtype of AML, the patient’s age, and overall health.
- 1. Chemotherapy: The primary treatment for AML. It is usually administered in two phases:
- Induction Therapy: Aims to kill as many leukemia cells as possible to induce remission.
- Consolidation Therapy: Aims to destroy any remaining leukemia cells and prevent relapse.
- 2. Targeted Therapy: Uses drugs that specifically target certain proteins or genetic changes in leukemia cells. Examples include FLT3 inhibitors and IDH inhibitors.
- 3. Radiation Therapy: Uses high-energy radiation to kill cancer cells or keep them from growing. It is less commonly used for AML but may be used in certain situations, such as before a stem cell transplant.
- 4.Stem Cell Transplant: Also known as a bone marrow transplant, this procedure involves replacing the diseased bone marrow with healthy stem cells. There are two types:
- Autologous Transplant: Uses the patient's own stem cells.
- Allogeneic Transplant: Uses stem cells from a donor.
- 5. Supportive Care: Includes treatments to manage symptoms and side effects, such as blood transfusions, antibiotics, and medications to manage nausea and pain.
Cost of AML Treatment in India
The cost of AML treatment in India ranges from ₹5,00,000 to ₹35,00,000 (USD 6,000 to USD 42,000), depending on the treatment type (chemotherapy, targeted therapy, or stem cell transplant). Chemotherapy may cost around ₹18,000 per session (USD 231), while a bone marrow transplant costs ₹10,00,000 to ₹15,00,000 (USD 12,884 to USD 19,326).
Duration of Stay for Treatment in India
Treatment duration depends on the plan:
- Induction Therapy: 4–6 weeks of hospitalization.
- Consolidation Therapy: Several months with multiple cycles of chemotherapy.
- Stem Cell Transplant: Weeks to months, including recovery.
The overall stay may span several months based on individual response and treatment phases.