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Acute Myelomonocytic Leukemia (AML-M4) – Symptoms, Treatment & Support

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Posted by adeel | Jun 14, 2020

What is Acute Myelomonocytic Leukemia?

Acute Myelomonocytic Leukemia (AML-M4) is a rare acute subtype of myeloid leukemia(white blood cell malignancy) with 20 percent or more myeloblasts (immature white blood cell)  in the bone marrow and peripheral blood, distinguished by the excessive multiplication of both neutrophil and monocyte progenitors(ancestor cells).

Disease Epidemiology

Acute Myelomonocytic Leukemia constitutes approximately 15–25 percent among all AMLs. The median age of onset of the disease is around 50 years, but it can occur at any age. It is more common in adults. The Incidence rate (frequency of disease occurrence) is marginally greater for males as compared to females.

Disease Etiology 

Causes are the same as for acute myeloid leukemia.  Following conditions have the congenital (by birth) predisposition towards Causing AML-M4:

  • Down syndrome
  • Bloom syndrome
  • Congenital neutropenia
  • Klinefelter’s syndrome
  • Ataxia telangiectasia
  • Fanconi’s anemia

Acquired predisposing determinants are:

  • Aplastic anemia
  • Myelodysplastic syndrome
  • Paroxysmal Nocturnal hemoglobinuria( PNH)
  • Exposures to certain radiations
  • Previous treatment with chemotherapy
  • Exposure to certain chemicals like benzene, petroleum, herbicides, and pesticides
  • Fetal exposure to tobacco, alcohol, and marijuana

 Sign And Symptoms

Sign and symptoms include symptoms of bone marrow and extramedullary ( outside the bone marrow like in skin, spleen, liver, and gums, etc.) infiltration( accumulation) by leukemic cells( cancerous white blood cells ), anemia( decreased red blood cell count or hemoglobin)  and thrombocytopenia( decreased platelet count). These are:

Symptoms of anemia associated with AML-M4

Fatigue, Shortness of breath (difficulty in breathing, pallor (paleness of skin and conjunctiva)

Symptoms of decreased platelet count associated with AML-M4

Fever and bleeding disorder (bleeding and easy bruising)

Sign and symptoms of bone marrow and extramedullary infiltration associated with AML-M4:

Bone pains, gingival hyperplasia (overgrowth of gum tissues around the teeth), Enlargement of lymph nodes, enlargement of spleen and liver and skin lesions.  

Diagnosis and Treatment

Following Laboratory investigations, procedures, and genetics studies are required to make an appropriate diagnosis. These are:

  • Complete blood count (CBC) with peripheral blood smears 
  • Liver function tests (LFTs)
  • Renal Functional Tests (RFTs)
  • Blood electrolyte levels
  • Coagulation profile: Prothrombin time (PT) and activated partial thromboplastin time

Gold standard/definitive tests are: 

  • Bone marrow smears
  • Bone marrow biopsy
  • Flow cytometry
  • Molecular and cytogenetic analysis for cytogenetic abnormalities of (16)(p13;1q22), t(16;16)(p13.1q22) or t(9;11)(p22;q23) and mutation in TET2 gene. 

Treatment options include chemotherapy, radiotherapy and bone marrow transplantation.  

 


   

 

What support can we give for Acute Myelomonocytic Leukemia?

Acute Myelomonocytic Leukemia is a rare cancer, meaning it is not as well known as other forms of cancer. Without a Ribbon is an Australian organisation that provides support for individuals who suffer from rare cancers. We provide a designated platform for Warriors to obtain information specific to their Rare Cancer. We also provide annual opportunities for our Warriors to meet and learn from each other. If you suffer from a rare cancer such as Acute Myelomonocytic Leukemia, we can help and support you through your journey thanks to the generous donations we receive. Click the link below to sign up and become a Warrior today!

 

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Without a Ribbon is a charity that works hard to aid those who suffer from rare cancers. You can help our cause in a variety of ways:

Donations — Without a Ribbon is grateful when we receive every donation. Giving to Without a Ribbon helps us to provide ongoing support, organise the annual gathering and subsidise the costs of our Warriors attending these conferences.

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Volunteering — We are always looking for volunteers to help with different aspects of running our charity. So, if you are looking for volunteer work, please feel free to contact us.

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