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What Is AML? The Shock of Diagnosis

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Published on January 15, 2021

Doctor Explains Acute Myeloid Leukemia Diagnosis

In this first episode of a nine-part podcast series, Eunice Wang, MD, Chief of Leukemia at Roswell Park Comprehensive Cancer Center, offers a thorough explanation of what it means to be diagnosed with acute myeloid leukemia (AML). Dr. Wang clarifies what is happening in your body, why there are no "stages" with blood cancers, and why an AML patient and their care partner should be hopeful, despite the shock of the diagnosis.

Support for this series has been provided by AbbVie Inc. and Genentech, Inc. Patient Power maintains complete editorial control and is solely responsible for program content.

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Transcript | What Is AML? The Shock of Diagnosis

Dr. Wang: Hello, my name is Dr. Eunice Wang, the Chief of the Leukemia Service at Roswell Park Comprehensive Cancer Center in Buffalo, New York. If you or a loved one has just been diagnosed with AML, it can be a devastating, shocking, life-changing experience. So let's talk about AML. What is this disease? Many of us feel that this is a very aggressive cancer that needs to be addressed or treated right away, but you need to understand what is happening in your body or in your loved one's body right now.

What is AML?

So acute myeloid leukemia is essentially an aggressive blood cancer. There are two types of blood cancer. One is acute or aggressive blood cancer, meaning that this has developed over the last weeks to maybe a month or two. And there's chronic blood cancers, which means that they develop much more slowly over a matter of months to years. What you have is an aggressive blood cancer, which typically, although not always, occurs in older individuals. That means that your white blood cells, which make up the immune system in your body, have transformed into a cancer. And when it does that, it takes over your bloodstream as well as the source of the bloodstream, which lies in the bone marrow. So, at the current time, over 20% of the cells in your bone marrow or in your blood consists of these blood cancer cells.

Now, these cells are in your bloodstream and within your bones. So one question that I get a lot is what stage is my leukemia? It's important to recognize that unlike solid tumors like breast cancer or lung cancer, or prostate cancer, at diagnosis of a leukemia, your cancer's already throughout your entire body because you have blood cells and blood vessels in every single organ of your body. So we typically say you either have the disease or you have no evidence of the disease and your blood counts are normal. And that is called a remission.

This type of blood cancer is characterized by different types of white blood cells that have become cancerous. So those that are from what we call the M line of development, or myeloid or myelogenous line, means that it's coming from a white blood cell that's of the M lineage or the M type. In contrast, there's other aggressive acute leukemias that originate from cells that are called lymphoid cells. And so for those individuals, we give them a different term. We call them acute lymphocytic leukemia.

So, in summary, what you or your loved one has is an aggressive blood cancer which is taking over your blood and your bone marrow and is affecting your body's ability to make normal immune cells, red cells and platelets that clot your blood. This is something that is not staged, but is throughout your entire system and generally requires treatment with agents that are going to be what we call chemotherapy or agents that are going to be taken by mouth or in your bloodstream or something that's going to go throughout your body to attack and destroy and hopefully remove as many of the blood cancer cells throughout your entire system as quickly as possible. So this is not a cancer that we do surgery for because there isn't one site of disease. It's also a cancer that we don't do radiation for, because again, it's throughout your entire system.

What Advice Do You Have for AML Patients?

The most important thing for you to remember is to maintain your sense of hope. This is a journey that you or your loved one is going to have to take. And I want to assure you that we have many new and effective treatments for this disease. Just in the last three or four years, there have been eight or nine new therapies approved for the treatment of AML. Many of these new therapies are pills that you can take at home. So, I want you to be assured that we have many new therapies for you and that many of our patients now are going into remission and having their disease controlled for months or in some cases even years.


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