Myeloid

What is myeloid?

Myeloid refers to bone marrow and cells derived from bone marrow. It's a term often used in hematology (the study of blood and blood disorders) and oncology to describe affected blood cells. Myeloid cancers that affect the blood and bone marrow include:

• Acute Myeloid Leukemia (AML): A fast-growing cancer of the blood and bone marrow. AML is relatively rare. The American Cancer Society estimates that there will be about 20,830 new cases of AML in the United States in 2024. The lifetime risk of getting AML is around 1 in 285.
• Chronic Myeloid Leukemia (CML): A slow-growing cancer of the blood and bone marrow. CML is also relatively rare. The American Cancer Society estimates that there will be about 8,860 new cases of CML in the United States in 2024. The lifetime risk of getting CML is around 1 in 513.
• Myelodysplastic Syndromes (MDS): A group of cancers in which the bone marrow does not produce enough healthy blood cells. MDS is more common than AML and CML, but still not considered a common cancer overall. The American Cancer Society estimates that there will be about 12,770 new cases of MDS in the United States in 2024. The lifetime risk of getting MDS is around 1 in 417.
• Myeloproliferative Neoplasms (MPNs): A group of cancers in which the bone marrow produces too many blood cells. As a group, MPNs are relatively rare, but the occurrence varies depending on the specific type of MPN. It's more difficult to give an overall incidence rate for MPNs because they include several different conditions. The most common MPNs are polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF).

At the AHN Cancer Institute, our team of hematologic cancer specialists provide the most effective treatments for blood cancers. AHN delivers comprehensive, compassionate care while using the latest advancements in medical technology. This difference allows our team to tailor care options to meet your specific needs.

The AHN team involved in your care collaborates to determine the optimal treatment plan for you. We partner with you to ensure an accurate diagnosis and develop a personalized treatment strategy. Leveraging the resources of the new AHN Cancer Institute Research Hub, we are advancing cancer care and providing it in a location convenient for you.

AHN Hematological Oncology Center of Excellence

Our Hematological Oncology Center of Excellence includes physicians dedicated to malignant and benign disorders of the blood. Through a multidisciplinary approach, Benign and Malignant Blood Cancer Center of Excellence health care providers coordinate with other areas of AHN to ensure all aspects of a patient’s health is considered and cared for. By doing so, you can experience a personalized level of care across the health system. We provide both inpatient and outpatient services and can offer treatment at AHN cancer institute sites throughout the region. The team also includes support from:

• Physician assistants
• Nurse practitioners
• Nurses
• Medical assistants
• Pharmacists
• Administrators

Why choose AHN for your blood cancer treatment?

AHN has a comprehensive cancer institute that likely encompasses a wide range of services specifically for blood cancers (also known as hematologic malignancies). At AHN, you can also expect:

• Specialized hematologists and oncologists: Our board-certified hematologists and oncologists specialize in the diagnosis and treatment of various blood cancers, such as leukemia, lymphoma, and myeloma.
• Multidisciplinary team approach: We use a multidisciplinary team approach, bringing together hematologists, oncologists, radiation oncologists, surgeons, pathologists, radiologists, nurses, and other specialists to provide coordinated care.
• Advanced diagnostic capabilities: We have state-of-the-art diagnostic tools, including advanced imaging (PET/CT, MRI), flow cytometry, cytogenetics, and molecular testing, to accurately diagnose and classify blood cancers. This is crucial for tailoring treatment.
• A wide range of treatment options: We offer a comprehensive range of treatment options for blood cancers, including CAR T-cell therapy, stem cell therapy, and radiation therapy.

Quick guide to myeloid cancer

Myeloid symptoms and signs

Myeloid screening and diagnosis

Types and stages of myeloid disorders

Myeloid treatment

Myeloid FAQs

Contact us

Myeloid disorder symptoms and signs

Similar to other conditions and diseases, symptoms that stem from cancer in the myeloid lineage can resemble other health issues and be linked to many other conditions. It’s important to be aware of your health and contact your health care provider if a new health issue persists, worsens, or starts to interfere with your daily life. Symptoms of cancer in the myeloid lineage differ based on the type. If you are experiencing any of these symptoms, it is important to see a doctor for proper evaluation and diagnosis.

Acute Myeloid Leukemia (AML) Symptoms

Symptoms for this fast-growing cancer of the blood and bone marrow may include:

• Fatigue and weakness: These symptoms are often due to anemia, which is a low red blood cell count.
• Frequent infections: Due to low white blood cell count, called leukopenia, people can experience frequent infections.
• Easy bleeding and bruising: For patients with low platelet count (thrombocytopenia), this can manifest as nosebleeds, bleeding gums, tiny red spots on the skin (petechiae), or heavier-than-normal menstrual periods in women.
• Bone pain: This is caused by the rapid growth of abnormal cells in the bone marrow.
• Fever: Often related to infections, those with AML can develop fevers more frequently.
• Weight loss: With AML, unintentional weight loss can occur.
• Swollen gums: In some cases, AML cells can infiltrate the gums, causing swelling.
• Enlarged liver or spleen: These organs may become enlarged due to the accumulation of leukemia cells. 

Chronic Myeloid Leukemia (CML)

Many people with CML have no symptoms initially, and it is often discovered during routine blood tests. CML symptoms may include:

• Fatigue and weakness: These symptoms are caused by anemia, which is a shortage of red blood cells.
• Night sweats: Night sweats can occur due to the overactive bone marrow and high white blood cell count.
• Weight loss: Unexplained weight loss can be a symptom of CML.
• Feeling full: An enlarged spleen can press on the stomach, leading to a sensation of fullness even after eating only a small amount of food.
• Bone pain: This pain can arise from the bone marrow as it becomes overcrowded with abnormal white blood cells, which can cause discomfort and aching sensations.
• Bleeding or bruising easily: This occurs due to a low platelet count, which impairs the blood's ability to clot effectively, leading to increased bruising and a tendency to bleed more easily.

Myelodysplastic Syndromes (MDS)

Symptoms of this cancer in the bone marrow may include:

• Fatigue and weakness: These are common symptoms caused by anemia, a condition where the body lacks enough healthy red blood cells to carry adequate oxygen to the tissues. This lack of oxygen delivery results in feelings of persistent tiredness, lack of energy, and overall weakness.
• Frequent infections: A low white blood cell count (leukopenia) weakens the body's immune system, making individuals more susceptible to bacterial, viral, and fungal infections. These infections may be more frequent, severe, and difficult to treat.
• Easy bleeding and bruising: A low platelet count (thrombocytopenia) impairs the blood's ability to clot properly. This can lead to easy bruising, prolonged bleeding from minor cuts, frequent nosebleeds, bleeding gums, and the development of tiny red or purple spots on the skin (petechiae).
• Shortness of breath: This symptom also stems from anemia. With a reduced number of red blood cells, the body struggles to deliver sufficient oxygen to the lungs and other organs, leading to breathlessness, especially during physical activity.

Myeloproliferative Neoplasms (MPNs)

MPNs include several different conditions, and the signs and symptoms can vary. MPN symptoms may include:

• Fatigue
• Night sweats
• Itching (especially after a warm bath or shower)
• Fever
• Unexplained weight loss
• Bone pain
• Enlarged spleen (causing abdominal discomfort or feeling full)
• Easy bleeding or bruising

Specific types of MPN have differing symptoms. These can include:

• Polycythemia vera (PV) specific symptoms:
  • Headacheo Dizziness
  • Vision changes
  • Redness of the skin (especially the face)
  • Shortness of breath
  • Itching after a hot shower
• Essential thrombocythemia (ET) specific symptoms:
  • Headaches
  • Dizziness
  • Vision changes
  • Tingling or burning in the hands and feet
  • Blood clots (which can lead to stroke or heart attack)
  • Bleeding
• Primary myelofibrosis (PMF) specific symptoms:
  • Enlarged spleen (often significantly)
  • Fatigue
  • Night sweats
  • Bone pain
  • Fever
  • Weight loss

Causes and risk factors

Myeloid cancers are a group of cancers that affect the blood and bone marrow. They start in the cells that normally develop into different types of blood cells like red blood cells, white blood cells, and platelets. It's important to understand that in many cases, researchers don’t know exactly what causes someone to develop myeloid cancer. In some cases, DNA damage and abnormal blood cells can contribute to myeloid cancers, but more research is needed to determine how this happens. However, scientists have identified certain factors that can increase one's risk for the development of a myeloid malignancy.

A risk factor is anything that makes it more likely that a person will develop a disease like cancer. Having a risk factor doesn't mean a person will develop cancer, and many people with risk factors never develop the disease. Known risk factors for myeloid cancers include:

• Age: While myeloid malignancies can occur at any age, risk of developing myeloid cancers increases with age.
• Exposure to certain chemicals:
  • Benzene: This chemical is used in the manufacturing of plastics, rubber, dyes, detergents, and some pesticides. Long-term exposure, especially at high levels, can increase the risk.
  • Tobacco smoke: Smoking cigarettes, cigars, or other tobacco products increases the risk.
• Radiation exposure: High doses of radiation — such as from radiation therapy for cancer or from a nuclear accident — can increase risk.
• Previous cancer treatment: Some chemotherapy drugs, especially alkylating agents and topoisomerase II inhibitors, can increase the risk of developing myeloid cancer years later. This is called "secondary" cancer.
• Blood disorders: Conditions such as myelodysplastic syndromes (MDS) or myeloproliferative neoplasms (MPNs) can increase the risk of developing myeloid cancer. These disorders affect the bone marrow and blood cells.
• Genetic syndromes: Inherited conditions like Down syndrome, Fanconi anemia, and Li-Fraumeni syndrome are linked with a higher risk.
• Family history: While most myeloid cancers are not inherited, having a family history of blood cancers may slightly increase the risk.

BACK TO TOP

Myeloid screening and diagnosis

Myeloid cancers often don't cause symptoms early on, so there aren’t routine screening tests specifically designed to detect them in people who feel healthy. Usually, myeloid cancers are diagnosed when someone goes to the doctor because they're experiencing symptoms that might be related to a blood disorder or when they have been experiencing unusual health symptoms. After a physical exam, your doctor may order screenings and diagnostic tests:

• Complete blood count (CBC) with differential: This is often the first-line test. It measures red blood cells, white blood cells, and platelets, and can indicate abnormalities that suggest a myeloid disorder.
• Peripheral blood smear: A blood sample is examined under a microscope to look for abnormal cells.
• Bone marrow aspiration and biopsy: These tests are more invasive and involve taking samples of bone marrow to examine the cells and tissue. They are often used to confirm a diagnosis.
• Flow cytometry: This test analyzes cells in the blood or bone marrow to identify specific markers on the cell surface, which can help diagnose different types of myeloid disorders.
• Cytogenetic analysis: This looks at the chromosomes in the cells to identify any abnormalities.
• Molecular genetic testing: This can detect specific gene mutations associated with myeloid disorders.

BACK TO TOP

Types and stages of myeloid disorders

Myeloid cancers are a group of cancers that originate in the bone marrow, affecting the myeloid line of blood cells. The cell line produces red blood cells, platelets, and certain types of white blood cells (such as neutrophils, basophils, eosinophils, and monocytes). These cancers occur when genetic mutations disrupt the normal development and function of these cells, leading to an overproduction of abnormal cells that crowd out healthy ones. Myeloid cancers can be broadly classified into acute and chronic forms, based on the speed of progression and the maturity of the abnormal cells. Your AHN care team will provide you with an in-depth overview if you have been diagnosed with a certain type of myeloid cancer and will determine the best treatment course.

Acute Myeloid Leukemia (AML)

Acute Myeloid Leukemia (AML) is a rapidly progressing cancer of the blood and bone marrow. It's characterized by the uncontrolled growth of immature myeloid cells, called blasts, which accumulate in the bone marrow and interfere with the production of normal blood cells. The term "acute" means that the disease progresses quickly if not treated.

AML is characterized by:

• Rapid progression: AML is acute, meaning it develops and worsens quickly, often within weeks or months.
• Cell maturity: Too many immature cells (blasts) are made making it impossible for the bone marrow (factory that makes red cells, platelets, white cells) to work properly.
• Genetic abnormality: AML has a variety of genetic mutations that can be associated with the disease.
• Treatment: AML requires aggressive treatment with chemotherapy and sometimes stem cell transplantation to achieve remission.

AML is not staged in the traditional sense like solid tumors. Instead, it's classified based on the factors like:

• Specific type of AML: There are many subtypes of AML, each with its own characteristics and prognosis.
• Cytogenetic and molecular abnormalities: Specific genetic mutations can affect the prognosis and treatment response.
• Whether it's newly diagnosed or relapsed: Relapsed AML is more difficult to treat.
• Patient's overall health and age: These factors can influence treatment options and outcomes.

Chronic Myeloid Leukemia (CML)

Chronic Myeloid Leukemia (CML) is a slow-growing cancer of the blood and bone marrow characterized by the overproduction of mature and maturing myeloid cells. It's associated with a specific genetic abnormality called the Philadelphia chromosome, which results from a translocation (exchange of genetic material) between chromosomes 9 and 22, creating the BCR-ABL fusion gene. This gene produces an abnormal protein (BCR-ABL tyrosine kinase) that drives the uncontrolled growth of myeloid cells.

CML is characterized by:

• Progression: CML progresses slowly over years, often starting in a chronic phase that can last for several years before potentially progressing to an accelerated or blast phase.
• Cell maturity: In CML, the abnormal cells are more mature and function somewhat normally, especially in the early stages.
• Genetic abnormality: CML is primarily associated with the Philadelphia chromosome (BCR-ABL fusion gene).
• Treatment: CML can often be managed effectively with targeted therapies called tyrosine kinase inhibitors (TKIs), which specifically block the activity of the BCR-ABL protein.

Like AML, CML is not staged but is rather classified in phases. These phases include:

• Chronic phase: This is the initial phase, where the disease is relatively stable, and patients may have few or no symptoms.
• Accelerated phase: The disease becomes more aggressive, with increasing numbers of immature cells (blasts) in the blood and bone marrow. Symptoms may worsen.
• Blast phase: This is the most advanced phase, where the disease transforms into acute leukemia, with a high percentage of blasts in the blood and bone marrow.

Myelodysplastic Syndromes (MDS)

Myelodysplastic Syndromes (MDS) are a group of closely related blood disorders characterized by ineffective blood cell production (dysplasia) in the bone marrow. In MDS, the bone marrow produces abnormal or immature blood cells that don't function properly. This leads to a deficiency of one or more types of blood cells: red blood cells (anemia), white blood cells (leukopenia), and platelets (thrombocytopenia). MDS can range from mild to severe and, in some cases, can transform into acute myeloid leukemia (AML).

MDS is not staged in the traditional sense. Instead, risk stratification systems, such as the Revised International Prognostic Scoring System (IPSS-R), are used to assess the prognosis and guide treatment decisions. The IPSS-R takes into account factors like:

• Percentage of blasts in the bone marrow.
• Cytogenetic abnormalities.
• Severity of cytopenias (low blood cell counts).
• Number of affected cell lines.

Myeloproliferative Neoplasms (MPNs)

Myeloproliferative Neoplasms (MPNs) are a group of blood cancers characterized by the overproduction of one or more types of blood cells in the bone marrow. Unlike MDS, where the blood cells are often abnormal and don't function properly, in MPNs, the blood cells are generally more mature and functional, but they are produced in excessive numbers. MPNs can cause a variety of symptoms and complications, including blood clots, bleeding, and enlargement of the spleen and liver. Some MPNs can also transform into acute leukemia. The three most common types of MPNs are:

• Polycythemia vera (PV)
• Essential thrombocythemia (ET)
• Primary myelofibrosis (PMF)

Polycythemia Vera (PV)

Polycythemia vera (PV) is an MPN characterized by the overproduction of red blood cells in the bone marrow, leading to an abnormally high red blood cell count. This can cause the blood to become thicker, increasing the risk of blood clots. Most people with PV have a mutation in the JAK2 gene. Diagnosis involves blood tests to identify an elevated red blood cell count and hemoglobin level, as well as testing for the JAK2 mutation. A bone marrow aspiration and biopsy may also be performed.

Essential Thrombocythemia (ET)

Essential thrombocythemia (ET) is an MPN characterized by the overproduction of platelets in the bone marrow, leading to an abnormally high platelet count. While the platelet count is elevated, the platelets may not function normally, increasing the risk of both blood clots and bleeding. JAK2, CALR, or MPL gene mutations are common in ET. Diagnosis involves blood tests to identify an elevated platelet count and exclude other causes of thrombocytosis (high platelet count). Testing for JAK2, CALR, and MPL mutations is also performed. A bone marrow aspiration and biopsy may be needed.

Primary myelofibrosis (PMF)

Primary myelofibrosis (PMF) is an MPN characterized by progressive scarring (fibrosis) of the bone marrow, leading to a decrease in the production of blood cells. As the bone marrow becomes scarred, the spleen and liver may enlarge as they take over the function of producing blood cells (extramedullary hematopoiesis). JAK2, CALR, or MPL gene mutations are common in PMF. Diagnosis involves blood tests to identify abnormalities in blood cell counts, including anemia, thrombocytopenia, and leukocytosis (high white blood cell count). A bone marrow aspiration and biopsy are essential to confirm the diagnosis and assess the degree of fibrosis in the bone marrow. Testing for JAK2, CALR, and MPL mutations is also performed.

BACK TO TOP

Treatment for myeloid disorders

Treatment for myeloid cancers is complex and highly individualized, depending on the specific type of cancer, its stage, the patient's overall health, and other individual factors. The goal of treatment is typically to achieve remission (a state where there is no evidence of cancer in the body) and improve the patient's quality of life. AHN offers a comprehensive approach to myeloid cancer care, with a multidisciplinary team of experts who collaborate to develop personalized treatment plans. Our team includes hematologists, oncologists, radiation oncologists, surgeons, and supportive care specialists. AHN is also actively involved in clinical trials, offering patients access to the latest and most innovative treatments.

Chemotherapy

Chemotherapy is often used as the primary treatment for acute myeloid leukemia (AML) to achieve remission. It's also used in advanced myelodysplastic syndromes (MDS) to control the disease and prevent progression to AML. In some myeloproliferative neoplasms (MPNs), chemotherapy may be used to reduce high blood cell counts or control symptoms. Chemotherapy is commonly used in:

• Acute Myeloid Leukemia (AML): Chemotherapy is the mainstay of treatment for AML, often used in combination with other therapies.
• Advanced Myelodysplastic Syndromes (MDS): Chemotherapy may be used in higher-risk MDS to reduce the risk of transformation to AML.
• Some Myeloproliferative Neoplasms (MPNs): Chemotherapy and cytoreductive agents may be used to lower blood cell counts and control symptoms in PV, ET, and PMF.
• Blast Phase CML: Chemotherapy is used to treat the blast phase of CML.

AHN's hematologists and oncologists have extensive experience in using chemotherapy to treat myeloid cancers. We carefully select the appropriate chemotherapy regimen based on the specific type of cancer, genetic mutations, and the patient's overall health. Our supportive care team helps patients manage the side effects of chemotherapy, such as nausea, fatigue, and hair loss.

Targeted Therapy

Targeted therapies are used in several types of myeloid cancers, often based on specific genetic mutations or abnormalities present in the cancer cells. For example, tyrosine kinase inhibitors (TKIs) are used to treat chronic myeloid leukemia (CML) by blocking the activity of the BCR-ABL protein. Targeted therapy is often used to treat: 

• Chronic Myeloid Leukemia (CML): Tyrosine kinase inhibitors (TKIs) are the standard treatment for CML, targeting the BCR-ABL protein.
• Acute Promyelocytic Leukemia (APL): A subtype of AML treated with all-trans retinoic acid (ATRA) and arsenic trioxide, which target specific proteins involved in APL.
• Some AML Subtypes: Some AMLs with specific mutations (e.g., FLT3 mutations) may be treated with FLT3 inhibitors.
• Myelofibrosis (MF): JAK2 inhibitors (e.g., ruxolitinib) can reduce spleen size and control symptoms in MF.

AHN is at the forefront of targeted therapy for myeloid cancers. Our experts have extensive experience in using targeted therapies to treat various types of myeloid cancers, and we actively participate in clinical trials to evaluate new targeted therapies.

Immunotherapy

Immunotherapy is a type of cancer treatment that uses the body's own immune system to fight cancer. These therapies work by helping the immune system recognize and attack cancer cells. Immunotherapy can involve different approaches, such as stimulating the immune system, providing immune cells, or blocking signals that prevent the immune system from attacking cancer cells. There have been advancements in using immunotherapy for myeloid cancers. These cases include:

• Acute Myeloid Leukemia (AML): Immunotherapy, such as checkpoint inhibitors, may be used in some cases of relapsed or refractory AML. Clinical trials are also exploring the use of CAR T-cell therapy and other immunotherapies in AML.
• Myelodysplastic Syndromes (MDS): Immunomodulatory drugs (IMiDs) like lenalidomide can stimulate the immune system to attack MDS cells, especially in MDS with specific genetic abnormalities.
• Post-Transplant: Immunotherapy can be used after stem cell transplant to prevent relapse.

AHN is actively involved in clinical trials evaluating new immunotherapies for myeloid cancers. We have a team of experts who are experienced in using immunotherapy to treat cancer and manage its side effects. We are committed to providing our patients with access to the latest and most promising immunotherapeutic options.

Clinical trials

Because AHN is participating in active clinical trials for blood cancer, patients may have the ability to participate if they meet the criteria. Clinical trials provide opportunities to see how different treatments may be effective in different patients and their response to the new treatment option.

Stem cell transplant (bone marrow transplant)

Stem cell transplant is typically used as a consolidation therapy after a patient has achieved remission from AML or MDS with chemotherapy. It can also be used as a primary treatment option for patients with high-risk MDS or relapsed AML.

The type of stem cell transplant that is often used is called allogeneic transplant. This is when stem cells are collected from a healthy donor (a sibling, unrelated matched donor, or haploidentical donor) and infused into the patient. Allogeneic transplants have the added benefit of graft-versus-leukemia effect, where the donor's immune cells can recognize and attack any remaining cancer cells in the patient's body.

AHN has a comprehensive stem cell transplant program with experienced transplant physicians, nurses, and support staff. We offer both autologous and allogeneic stem cell transplants, including transplants from matched unrelated donors and haploidentical donors. We also actively participate in clinical trials evaluating new approaches to stem cell transplantation.

AHN is classified as a FACT (Foundation for the Accreditation of Cellular Therapy) transplant center. This is an independent organization that sets the highest standards for the quality and safety in cellular therapy, including stem cell (bone marrow) transplant programs. Fact accreditation means:

• The center meets rigorous standards for patient care, lab processing, and transplant procedures.
• The transplant program follows best practices for donor and patient safety.
• The facility undergoes regular inspections and continuous quality improvement. 

Radiation therapy

Radiation therapy is not as commonly used in the treatment of myeloid cancers as chemotherapy or stem cell transplant. However, it may be used in certain situations, such as:

• Palliative radiation: To relieve symptoms caused by enlargement of the spleen or liver in patients with myelofibrosis.
• Total body irradiation (TBI): As part of the conditioning regimen before stem cell transplant.

In some situations, there are specific myeloid cancers where radiation therapy may be used:

• Myelofibrosis (MF): Radiation therapy may be used to shrink an enlarged spleen and relieve symptoms.
• Before stem cell transplant: Total body irradiation (TBI) may be used as part of the conditioning regimen to prepare the bone marrow for the transplant.
• Localized disease: In rare cases, radiation may be used to treat localized collections of myeloid cancer cells.

Supportive care

AHN offers a specialized area of treatment that includes Support Services for Cancer Patients. This is an essential part of cancer treatment that focuses on managing the side effects of cancer and its treatment, as well as improving the patient's overall quality of life. Supportive care can include a wide range of services, such as:

• Pain management: Medications and other therapies to relieve pain caused by cancer or its treatment.
• Nutritional support: Guidance on healthy eating and supplements to maintain strength and energy during treatment.
• Management of nausea and vomiting: Medications and other techniques to prevent or reduce nausea and vomiting caused by chemotherapy.
• Blood transfusions: To treat anemia or thrombocytopenia caused by cancer or its treatment.
• Infection prevention and treatment: Measures to prevent infections and antibiotics to treat infections that do occur.
• Emotional support: Counseling, support groups, and other resources to help patients cope with the emotional challenges of cancer.
• Social work services: Assistance with financial, insurance, and logistical issues related to cancer treatment.

AHN's holistic approach ensures that patients receive not only the most advanced medical treatments, but also the essential supportive care they need to maintain their physical and emotional well-being throughout their treatment.

BACK TO TOP

Myeloid cancer FAQs

A myeloid cancer diagnosis can bring about many questions, emotions, and perhaps a feeling of overwhelm. We’re here to help. Your AHN care team is available to answer any and all questions and will be with you through your treatment. To help get you started, we’ve compiled some answers to frequently asked questions that may help guide your conversations with your care team.

Is acute myeloid leukemia (AML) curable?

Yes, acute myeloid leukemia (AML) can be curable. The likelihood of a cure depends on several factors, including:

• The specific subtype of AML: Some subtypes of AML have a better prognosis than others.
• The patient's age and overall health: Younger patients and those in good overall health tend to have a better chance of being cured.
• Genetic mutations: Certain genetic mutations can affect the prognosis and treatment response.
• Response to treatment: Achieving remission after initial treatment is a good sign, but many patients will need further treatment like stem cell transplant to prevent relapse and achieve a long-term cure.

Treatment for AML typically involves intensive chemotherapy to induce remission, followed by consolidation therapy (such as stem cell transplant or additional chemotherapy) to prevent relapse. The goal is to eliminate all detectable cancer cells from the body and allow the bone marrow to recover and produce normal blood cells.

What is the difference between acute myeloid leukemia and chronic myeloid leukemia?

The key differences between acute myeloid leukemia (AML) and chronic myeloid leukemia (CML) lie in their speed of progression, the maturity of the abnormal cells, and the underlying genetic abnormalities:

• Progression: AML is an acute leukemia, meaning it develops and progresses rapidly, often within weeks or months. CML is a chronic leukemia, progressing slowly over years, and has different phases of progression.
• Cell maturity: In AML, the abnormal cells are very immature (blasts) and do not function properly. In CML, the cells are more mature and may function somewhat normally, especially in the early stages.
• Genetic abnormality: AML has a variety of genetic mutations with no single defining mutation. CML is primarily associated with a specific genetic abnormality called the Philadelphia chromosome, which results in the BCR-ABL fusion gene.

In summary, AML is a fast-growing cancer of immature blood cells, while CML is a slow-growing cancer of more mature blood cells with a specific genetic abnormality.

Which is worse: acute myeloid leukemia or chronic myeloid leukemia?

Generally speaking, acute myeloid leukemia (AML) is considered more immediately serious than chronic myeloid leukemia (CML) at the time of diagnosis. Here's why:

• Speed of progression: AML progresses very rapidly and can be life-threatening within weeks or months if left untreated. CML progresses slowly and can often be managed for many years with treatment.
• Treatment intensity: AML requires intensive and aggressive treatment with chemotherapy and often stem cell transplant to achieve remission. CML can often be managed with targeted therapies (tyrosine kinase inhibitors) that have fewer side effects than chemotherapy.
• Risk of complications: AML is associated with a higher risk of complications, such as infections, bleeding, and organ failure, due to the rapid accumulation of abnormal cells in the bone marrow.

However, it's important to note that both AML and CML can be serious and potentially life-threatening if not treated properly. The long-term prognosis for both diseases depends on various factors, including the specific subtype, genetic mutations, response to treatment, and the patient's overall health.

Can chronic myeloid leukemia turn into acute?

Yes, chronic myeloid leukemia (CML) can transform into an acute leukemia. This is known as "blast crisis" or "blast phase" CML. In blast crisis, the CML cells become more immature and aggressive, resembling acute leukemia cells (blasts). The disease progresses rapidly, and patients may experience a sudden worsening of symptoms. The blast phase can occur in patients who have not responded to treatment or who have developed resistance to tyrosine kinase inhibitors (TKIs). It is a serious complication of CML and requires intensive treatment with chemotherapy and sometimes stem cell transplant.

While modern treatments like TKIs have significantly reduced the risk of CML transforming into blast crisis, it is still a possibility, especially in patients who do not adhere to their treatment or who develop resistance to TKIs. Regular monitoring and close follow-up with a hematologist are essential for patients with CML to detect any signs of disease progression or transformation.

BACK TO TOP

Contact us

Call the Division of Hematology and Cellular Therapy at 412-578-4484 to make an appointment with a hematologist. Patients needing immediate care are usually admitted to AHN West Penn Hospital and care is coordinated from there. Patients are otherwise seen in the outpatient office in the Mellon Pavilion. Once scheduled, our staff will instruct you on what is needed so that our doctors get access to your medical records.

Second opinions

If you have cancer, you have a team of oncology specialists ready to review your medical records and offer you a second opinion. After completing their review, they’ll talk with you about your goals to determine a course of treatment that’s right for you. To get started, fill out our Second Opinion Request form. A nurse navigator will contact you within the next 24 to 48 hours to discuss next steps and schedule.

BACK TO TOP