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Causes and characteristics of acute myeloid leukemia

We talk about acute leukemia when hematopoiesis is blocked at an early stage of the production of blood cells. Malignant cells that proliferate are so immature (called cells "blast"). They correspond to rapidly changing forms of involving patients' lives in the short term (as opposed to chronic forms). From acute leukemia, we differentiate acute lymphoblastic leukemia, affecting cell lineage (a type of white blood cell involved in the immune system), acute myeloid leukemia, which may affect the precursors of all other cells manufactured by bone marrow (red blood cells, platelets, some other white blood cells such as neutrophils).

Symptoms of acute myeloid leukemia

The most common acute leukemia begins abruptly in a few days, without signs, with a rapid deterioration of the general condition and a combination of symptoms. They often reflect the inability of the bone marrow to produce blood cells normally, due to the proliferation of leukemic cells. Thus, the decrease in production of red blood cells causes anemia whose main clinical signs are pallor, shortness of breath, fatigue, rapid heartbeat ... The decrease in platelet exposed to bleeding, bruising, bleeding gum or skin. Finally, the reduction in the number of white blood cells (neutrophils) may cause infectious problems.

Diagnosis of acute myeloid leukemia

The diagnosis of acute leukemia can not be established after a single blood test. It is essential to make a cytological examination of bone marrow cells. This examination consists of the morphological analysis of marrow cells after removal of these cells by bone marrow aspiration. The myelogram is performed under local anesthesia by puncture of the sternum or iliac spine. Morphological analysis of these cells allows to define the subset of acute leukemia: acute lymphoblastic leukemia or acute myelogenous leukemia. Other laboratory tests allow additional data to better characterize the cells of the disease. Study of cellular proteins (phenotype), and study of cell chromosomes by karyotype can also refine the diagnosis and prognosis.

Treatment of acute myeloid leukemia

The treatment consists of administering chemotherapy, namely the use of a combination of several drugs. The first phase (induction phase) consists of chemotherapy and to the destruction of leukemic cells. However, it also destroys so transient, normal cells of the bone marrow and blood, which is responsible for the patient of a phase of aplasia (absence transient in the blood of normal blood cells). This condition should be carefully monitored because it increases the risk of infection. Then, the blood cell count goes up, and the patient leaves aplasia in which he found himself.

Other sequences of chemotherapy (called consolidation) must then be undertaken, details of which are based on age and risk of recurrence.

In some young patients with leukemia at high risk of recurrence, we can proceed to allogeneic hematopoietic stem cells from bone marrow ("marrow") or blood ("peripheral stem cell transplantation") if there is a donor.

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