Acute Myeloid Leukaemia

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What is Acute Myeloid Leukaemia?

Acute Myeloid Leukaemia is a type of leukaemia which arises from the precursors of the myeloid cells which would subsequently, in normal circumstances, evolve into normal white cells. Bone marrow is found inside most of the bones in the body. By adulthood, a large proportion of bone marrow has become relatively inactive. Generally speaking, it is the marrow inside the vertebra, ribs and pelvis, which is responsible for producing the blood cells in adults. In times of crisis or when these areas of bone marrow are damaged, marrow activity may switch on in the other bones. The bone marrow is a collection of cells inside a connective tissue and fatty stroma. Stem cells are the ultimate origin of the other cells. Stem cells differentiate to form 3 main types of 'progenitor' cells. Each of these cells is then responsible to produce red cells, white cells and megakaryocytes (which produce platelets). There are a number of proteins, which stimulate production of blood cells. These include erythropoietin, (EPO) granulocyte-macrophage colony stimulating factor (GM-CSF), granulocyte-CSF (G-CSF), Interleukin 3, 5 and 6 (IL-3, IL-5, IL-6). Generally speaking, these proteins interact with receptors on the surface of the primitive bone marrow cells and stimulate them to produce the adult cells.

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Acute Myeloid Leukemia

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Who gets Acute Myeloid Leukaemia?

Acute Myeloid Leukaemia is uncommon and occurs at any time of life, with average incidence of acute myeloid leukaemia being 2.3 per 100,000 people per year. Acute Myeloid Leukaemiausually occurs (80%) in adults with the majority of cases of acute myeloid leukaemia occurring in people over the age of 60, with sex incidence being equal. However, acute myeloid leukaemia can occur in children, especially if there is a predisposition for the leukaemia.

Predisposing Factors

The cause of most cases of acute myeloid leukaemia is unknown. Acute myeloid leukaemia often occurs on the background of another haematological (blood or bone marrow) condition, such as:

Myelodysplastic syndromes.
Chronic myeloid leukaemia.
Myelofibrosis.
Polycythaemia rubra vera.
Essential thrombocythaemia.
Severe aplastic anaemia. Acute myeloid leukaemia also occurs in individuals exposed to:
Previous radiotherapy or nuclear irradiation.
Previous chemotherapy with alkylating agents or certain other chemotherapy agents and certain organic chemicals such as Benzene and Toluene. Certain individuals may inherit a predisposition to acute myeloid leukaemia such as those with Fanconi's anaemia or Down's syndrome.