Acute Monocytic Leukemia: Causes, Symptoms, and Treatment – Healthline

Leukemia is a group of cancers that affect your bone marrow and cause your body to produce abnormal blood cells. Acute myeloid leukemia (AML) is the most common type of leukemia in adults and accounts for about 4 out of 5 adult cases.

Acute monocytic leukemia (AML-M5) is a subtype of AML, in which at least 80 percent of the affected blood cells are a type of white blood cell called monocytes. Half of the people diagnosed with AML M5 are older than age 49.

AML-M5 causes similar symptoms in the early stages as other types of leukemia. These symptoms include:

In this article, we take a look at how acute monocytic leukemia differs from other leukemias, how its treated, and whats the outlook.

Leukemias develop in bone marrow stem cells that produce blood cells. Theyre classified based on the type of blood cells affected and how quickly the disease progresses. Heres how each main type is broken down:

AML is a type of leukemia that develops quickly (acute) and affects myeloid cells (myeloid).

AML-M5 is a subtype of AML that mainly affects the growth of monocytes. Monocytes have the potential to become two other types of white blood cells called macrophages and dendritic cells.

According to the National Cancer Institute, AML-M5 is diagnosed when more than 20 percent of white blood cells are abnormal or not fully developed, and more than 80 percent of the abnormal cells are monocytes or cells derived from monocytes.

Like many types of cancer, its not entirely clear why AML-M5 develops in some people and not others. However, it has been linked to certain genetic mutations.

In a 2019 study, genetic mutations were detected in 83.3 percent of people with AML-M5. The mutations FLT3-ITD and NRAS were most common.

Symptoms of AML-M5 are similar to those of many other forms of leukemia. Symptoms like fatigue or feelings of weakness are general and can have many potential causes.

Some other possible symptoms of AML-M5 include:

Many of the symptoms of leukemia are general and can have many different causes. A healthcare professional will likely want to order a blood test to look for signs of the disease, such as a high number of abnormal white blood cells or a low blood count.

If your blood test reveals signs of leukemia, youll likely be referred to a doctor called a hematologist, who specializes in blood conditions.

The next part of your diagnosis will likely involve a bone marrow biopsy, usually from your hip bone. During this procedure, an anesthetic will be applied to your skin. Then, the doctor will use a thin needle to remove bone marrow from the center of your hip bone.

The procedure usually takes about 20 to 30 minutes and shouldnt be painful. Your sample will then be taken to a lab for analysis.

Other supportive tests may be used to collect more information about the specific type of AML you have, how far it has progressed, and what the best treatment option may be.

AML-M5 can be difficult to treat due to a limited amount of research on the best way to manage this specific type of AML.

Treatment for most forms of AML involves multidrug chemotherapy and bone marrow transplants. The amount of chemotherapy you can receive depends on factors such as your age and overall health.

The goal of induction chemotherapy is to kill as many cancer cells as possible. It involves taking a high dose of chemotherapy drugs that target cancer cells. Unfortunately, it also targets healthy cells in your body that divide rapidly, such as blood stem cells, skin cells, and gastrointestinal cells.

The strength of the chemotherapy you can handle may depend on your age or overall health. Chemotherapy drugs are highly toxic to your bone marrow and can cause bleeding complications, kidney failure, and other potentially serious side effects, so your doctor will run tests often to check your health.

The chemotherapy drug cytarabine and either daunorubicin or idarubicin are often used in a 7+3 regimen. This mean you get cytarabine through an IV for 7 days, along with a small dose of one of the other medications on the first 3 days.

Here are a few other variations in the way this treatment might work:

Typically, youll stay in the hospital during the induction phase. If there are still signs of cancer in your body at the end of treatment, you may need another round of chemotherapy.

After going into remission, meaning the cancer is no longer detectable, most people undergo additional chemotherapy to target any remaining undetectable cancer cells and keep the cancer from coming back.

Young and healthy individuals often undergo several cycles of high-dose cytarabine combined with bone marrow transplants. Older adults or those with other coexisting health conditions may receive lower doses of cytarabine or other chemotherapy drugs.

High doses of chemotherapy damage the cells in your bone marrow that produce blood cells. A bone marrow transplant replaces damaged cells with healthy ones. Two types of transplants may be performed:

When a suitable donor is available, allogeneic transplants are the preferred procedure.

The outlook for people with AML-M5 has not been clearly established. However, it is known that it often progresses quickly when left untreated.

When your body makes too much of a protein called differentiation inhibitory factor, it may be linked to a less promising prognosis in some people.

About 40 percent of people with AML-M5 have a mutation in their Flt3 gene, which also may be associated with a less favorable outcome.

In a 2020 study, researchers found the 5-year overall survival rate was 46 percent in a group of 132 children with AML-M5. The overall survival rate was lowest in children under 3 years old.

Researchers are continuing to study AML-M5 in clinical trials to find the best way to treat this type of leukemia. Its likely the survival rate will continue to improve with time and new data.

Many types of leukemia that used to have high mortality rates are now very treatable, thanks to medical advancements. You can ask your doctor about clinical trials in your area, or you can search for them yourself from the U.S. National Library of Medicine.

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Acute Monocytic Leukemia: Causes, Symptoms, and Treatment - Healthline