Published on October 9, 2020
Helpful Information from an AML Expert
What is acute myeloid leukemia (AML)? How and why does it occur? What is the prognosis once it is diagnosed? What should you know about treatment? Listen to an AML expert answer these questions and offer his advice to those who are newly diagnosed with the disease. Dr. Naval Daver, associate professor in the Department of Leukemia at MD Anderson Cancer Center, also shares information on treatment options.
Transcript | Acute Myeloid Leukemia Prognosis, Information and Advice
Dr. Daver: So, the research is only beginning, but I think now we really have the tools. We understand the preclinical data. We understand the molecular and immune biology better — not completely, but better than 10 years ago.
What is Acute Myeloid Leukemia?
Acute myeloid leukemia (AML) is a disease of the bone marrow. It is a condition that usually presents rapidly, with symptoms such as fatigue, weakness, infection, due to a sudden drop in the blood counts. And the way we think acute myeloid leukemia occurs is like with most other cancers, where there is a mutation or chromosome change in the cells in the bone marrow. And then these cells get a proliferation advantage. They start multiplying very quickly, and over time, they overcome and overrun the bone marrow.
And so, the normal cells are pushed out of the bone marrow, and the bone marrow is not able to do its routine function, which is to produce red cells, platelets, white cells, which are important components for us to be able to survive on a day to day basis. And so, the treatment for acute leukemia is to try to control that abnormal clone that is overcoming and overrunning the bone marrow to reset a normal hematopoiesis and production of the normal red cells, white cells and platelets.
What Should Newly Diagnosed AML Patients Know?
The most important thing I think to know about acute myeloid leukemia today is, number one, it is actually highly treatable. Number two, the cure rates are dramatically more than they were about two decades ago. The cure rates are about double of what they were.
Number three, even groups that we historically thought were very difficult to treat, such as older acute myeloid leukemia patients, about 65 or 70, or acute myeloid leukemia with what we call adverse or high-risk features, even for these groups now, we have new drugs and treatments that are showing activity.
And probably the most important is that treatment is no longer one size fits all. There is now molecular and chromosome-based, personalized selection of therapies and identifying the appropriate molecular or chromosome subset. And matching that to the appropriate personalized therapy has major, major impact and implications on not only response to treatment and survival, but also may offer lower intensity, better-tolerated treatment options instead of a traditional high dose chemotherapy.
The treatment does take time. It does significantly impact your lifestyle. And it usually does take a while, six months to a year, to complete the treatment and start feeling back to normal. So, one does have to be prepared for that, but if one can do all the treatments at a center with a lot of expertise experience, then there is hope, and high cure rates are now being seen.