World AML Awareness Day

What are your first thoughts when you hear the word Leukemia? You likely think of little kids, cancer, chemotherapy. You may even think, "well, that sucks, but at least there is a cure". If you think those things, you're mostly right. Leukemia is the most common childhood cancer. Leukemia  is a type of cancer of the blood and bone marrow, the tissue inside bones where blood cells are made. Children diagnosed with ALL, Acute Lymphocytic Leukemia, go through approximately two years of treatments and have a good chance for survival. Here's the problem: not all Leukemia is ALL. 

AML, Acute Myeloid Leukemia, is very different. What is the difference between AML and ALL? AML and ALL are both cancers of the blood and bone marrow. The main difference between the two is that AML affects the production of myeloblasts, red blood cells, and platelets, whereas ALL mainly affects the production of lymphocytes. The two main lymphocytes are: B lymphocytes which produce antibodies, whereas T lymphocytes help kill tumor cells and regulate the immune response. The Myeloblasts are a type of precursor white blood cells that mature into either neutrophils, basophils, or eosinophils. These types of white blood cells engulf and dissolve different pathogens, such as bacteria and viruses. Clearly we need all of these blood components to be properly manufactured in our system. More studies and research have been done to treat ALL, giving ALL patients a better prognosis.

With AML patients, the white blood cells that are produced are stunted. Due to gene, chromosomal changes or translocations, these white blood cells do not mature into the functioning cells they should. These "bad" cells rapidly multiply, crowding out the "good" cells. Normally your bone marrow works like an efficient production line, consistently making the exact number of blood cells and platelets that your body needs to function. With AML, however, your bone marrow produces abnormal myeloid cells, called myeloid blasts or myeloblasts.

Myeloid blasts don’t act like normal blood cells. Normal cells follow genetic directions that tell them when and how they should multiply and grow. As cells get older, they die to make room in your bone marrow for new cells. Myeloid blasts don’t follow directions. They multiply uncontrollably and they don’t die. The continuous flow of myeloid blasts in your bone marrow means less room for healthy blood cells. Since there’s no room, your bone marrow stops making blood cells. Without new healthy blood cells, your body doesn’t have what it needs to function, and as the myeloid blasts keep on multiplying, they begin to spill out of your bone marrow into your bloodstream. Once in your bloodstream, the myeloid cells travel to other parts of your body, including your nervous system, brain and spinal cord.

The overall five year survival rate for ALL pediatric patients is 90%, compared to AML patients which is 20%. Only 20%! That means that 80% of patients diagnosed with AML will not make it five years past the diagnosis. AML is a cancer that is more common in adults than children. It is sometimes a secondary cancer, meaning the treatment received to treat another disease may cause AML. It is rare in children, affecting an average of 700 pediatric patients in the US annually, as compared to ALL which has an average 25,000 US pediatric diagnoses.

As we observe international AML Awareness Day, please take a moment to think about those impacted. Think about the lack of money and research involved with solving this problem. Children are getting an adult diseases, and the treatment for this adult disease is geared toward adults. Maybe, just maybe if some money and research are invested into how to treat AML in pediatric patients we can raise the survival rate. No child should only have a 20% chance of survival. For Anna, with her diagnosis, her subtype, her chromosomal translocation, that 20% survival rate dropped to 5%. Yes, you read that right, 5%. A  kind, beautiful, athletic, smart teenage girl had only a 5% chance of beating AML. 5%. We must do better for those suffering with this diagnosis. We must do better to find a cure. We must do better.