Acute Myelocytic Leukemia Health Article

Coping with cancer treatment

One of the most important aspects of treatment is guaranteeing that the patient will have the supportive care needed to come through the treatment period with physical and emotional strength intact. Part of what this means is that AML should be treated in major cancer centers, because only these centers have the expertise necessary to provide not only the right medicine but also the accompaniments of good treatment.

One way physicians help AML patients cope with treatment is to guarantee that adequate blood bank support is available. Many patients require platelet transfusions.

One of the great dangers to patients during induction treatment and other steps of treatment is the threat of serious infectious disease. These patients have weakened blood components and are therefore more susceptible to infectious illness than the average person is. The leading cause of death for patients receiving induction treatment and chemotherapy following remission is infectious illness.

To help build the patient's white cell count, doctors may prescribe growth factors. These encourage the body to produce certain types of blood cells. The types of growth factors prescribed most frequently are granulocyte-colony stimulating factor (G-CSF) and granulocyte-macrophage colony stimulating factor (GM-CSF).

The psychological aspects of cancer treatment are a major concern. Patients should ask their physician about local support groups and survivor networks that can help with the stresses associated with this disease.

Prevention

High doses of radiation and exposure to the chemical benzene (used in the manufacture of plastics, rubber, and medicines) are strong risk factors. With the exception of people with such rare genetic conditions as Fanconi anemia, Klinefelter syndrome, Patau syndrome, Bloom syndrome, and Down syndrome, there is no known genetic predisposition to AML.

Resources

BOOKS

Braunwald, Eugene, et al. Harrison's Principles of Internal Medicine, 15th ed. New York: McGraw-Hill, 2001.

Pazdur, Richard, et al. Cancer Management: A Multidisciplinary Approach: Medical, Surgical, & Radiation Oncology, 4th ed. Melville, New York: PRR, 2000.

Steen, Grant, and Joseph Mirro. Childhood Cancer: A Handbook from St. Jude Children's Research Hospital. Cambridge, MA: Perseus Publishing, 2000.

PERIODICALS

Abramson, N., and B. Melton."Leukocytosis: Basics of Clinical Assessment." American Family Physician 63 (2000): 2053-60.

Hiddemann, W., et al. "Management of Acute Myeloid Leukemia in Elderly Patients." Journal of Clinical Oncology 17 (1999): 3569.

Lowenberg, B., et al. "Acute Myeloid Leukemia." New England Journal of Medicine 341 (1999): 1051.

Young, G., et al. "Recognition of Common Childhood Malignancies." American Family Physician 61 (2000): 2144-54

ORGANIZATIONS

Acute Myeloid Leukemia Treatment, Childhood. Acute Myeloid Leukemia Treatment, Adult. National Cancer Institute. (800) 4-CANCER. <http://www.nci.nih.gov>.

Acute Myelogenous Leukemia (AML).Emotional Aspects of Childhood Leukemia. Making Intelligent Choices About Therapy. Understanding Blood Counts. Patient Aid Program. Family Support Group. Information Resource Center. The Leukemia and Lymphoma Society. (800) 955-4572. <http://www.leukemia-lymphoma.org>.

Adult Acute Leukemia American Cancer Society. (800) ACS-2345. <http://www.cancer.org>.

Lata Cherath, Ph.D.

Bob Kirsch

Blasts

—An immature cell.

Bone marrow

—Spongy tissue found in the large bones of the body.

Cytogenetic testing

—Analysis of parts of the nucleus of blast cells.

Granulocytes

—White blood cells containing particles or granules.

Immunophenotype

—A test that involves placing various sorts of stains on bone marrow cells to help identify the chemicals located on the cell surfaces.

Monocytes

—Another type of white blood cell, important in the defense against pathogens.

QUESTIONS TO ASK THE DOCTOR

• What type of AML do I have? What does it mean to have this variant of the disease?
• How can I obtain supportive care so I come through this not only alive but with my family and emotional life intact?
• Do I have any infections?
• What are the results of the cytogenetic testing?
• What are the results of the immunophenotyping?
• What is my prognosis?
• Are blasts present?
• Are blood counts returning to normal levels?
• Has complete remission been achieved?
• What can I do to lower my risk of infection during chemotherapy?