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Acute Myeloid Leukemia (AML)

(also called acute myelogenous leukemia and acute nonlymphocytic leukemia)

What is acute myeloid leukemia (AML) in children?

Acute myeloid leukemia (AML) is a cancer of the blood and bone marrow.

In leukemia, cancer cells grow fast in the bone marrow. When this happens, healthy blood cells cannot do their jobs correctly. The cancer cells are immature white blood cells called blasts.

AML affects blood cells called myeloid stem cells. A myeloid stem cell becomes one of 3 types of mature blood cells:

  • Red blood cells
  • White blood cells called granulocytes
  • Platelets

AML is the second most common childhood leukemia after acute lymphoblastic leukemia (ALL).

About 500 children are found to have AML in the United States each year. Pediatric AML is most common in infants and toddlers under age 2 and in teens.

Treatment may include chemotherapy and stem cell transplant (bone marrow transplant).

The overall survival rate for AML in children is about 70% in the U.S. But every case is different. Your care provider can give you more information about your child’s case.

Basics of Blood

Learn more about leukemia and lymphoma causes, treatment, and side effects.

Explore the Basics of Blood

Microscope image that shows normal bone marrow

This image shows how normal, healthy bone marrow appears through a microscope.

Microscope image shows bone marrow of a patient with acute myeloid leukemia

This image shows how the bone marrow of a child with acute myeloid leukemia looks under the microscope.

Symptoms of acute myeloid leukemia

Signs and symptoms of AML may include:

  • Fever
  • Fatigue
  • Infections
  • Easy bruising and bleeding
  • Frequent nosebleeds
  • Pain in bones or joints
  • Pain or feeling of fullness under the rib cage
  • Swollen lymph nodes
  • Poor appetite

Risk factors for acute myeloid leukemia

Risk factors for AML in children include:

  • Having a brother or sister, especially a twin, with leukemia
  • Past treatment with chemotherapy or radiation
  • Myelodysplastic syndrome

People with certain inherited disorders may develop AML:

  • Aplastic anemia
  • Diamond-Blackfan syndrome
  • Familial platelet disorder
  • Fanconi anemia
  • Li-Fraumeni syndrome
  • Mismatch repair syndromes
  • MonoMAC syndrome
  • Rothmund-Thomson syndrome
  • Schwachman-Diamond syndrome

Diagnosis of acute myeloid leukemia 

The doctor will check general signs of health during a physical exam and health history. They will:

  • Look for signs of disease such as lumps or anything else that seems unusual
  • Examine the eyes, mouth, skin, and ears
  • Feel the patient’s belly for signs of an enlarged spleen, liver, and lymph nodes
  • Examine the testes in boys
  • Ask about the child’s personal and family history. The doctor is looking for possible inherited conditions that have an increased risk of cancer.

Tests to diagnose AML in children also include:

Tests to identify subtype

If cancer is found, doctors will do more tests to find out the cancer subtype. These tests look for tumor markers, changes in chromosomes, and certain genes and proteins.

Types of acute myeloid leukemia in children

AML has several subtypes. Knowing the subtype allows doctors to classify AML cases into low-risk or high-risk. This helps them select the best treatment.

Treatment based on risk category is called risk-adapted therapy. It has led to increased cancer survival rates.

Patients with high-risk forms of cancer may get the most aggressive therapy. Patients with low-risk cases may get lower-intensity treatment with fewer side effects.

To learn more about AML subtypes, ask your child’s doctor.

Treatment of acute myeloid leukemia 

Treatment depends on the type of AML. Three forms of AML are treated differently than other forms of AML. These types are:

  • Acute promyelocytic leukemia (APL)
  • AML in children with Down syndrome
  • FLT3-mutated AML

Chemotherapy is the most common AML treatment. Stem cell transplant (also called bone marrow transplant or hematopoietic cell transplant) may also be an option.

Research spotlight

Research using the body’s own immune cells may open the door for promising new treatments for AML.

Read the blog post

Prognosis for acute myeloid leukemia

The 5-year survival rate for childhood AML is about 70% in the U.S.

About 90% of children with AML have no cancer cells in their blood after initial treatment. About 30% of children have cancer that comes back (relapse) or have disease that resists treatment (refractory).

Support for patients with acute myeloid leukemia

Some AML patients may have late effects. These are health problems that occur months or years after treatment has ended.

Cancer patients should continue to see their treatment center care team and/or a local primary care provider after cancer treatment. Late effects can often be treated. Sometimes they can be prevented.

Different treatments may have different late effects. Not all patients will have late effects. Patients who had the exact same treatment may have different late effects.

AML patients may be at risk for:

Patients who have stem cell transplants may be at risk for certain late effects.

Questions to ask your care team

  • What are our treatment options? 
  • What are the possible side effects of each treatment? 
  • What can be done to manage side effects? 
  • Will my child need to be in the hospital for treatment? 
  • Where is the treatment available? Is it close to home or will we have to travel? 
  • Will the treatment affect my child’s ability to have children in the future? What options exist to preserve fertility?

Key points about acute myeloid leukemia

  • Acute myeloid leukemia (AML) is a cancer of the blood and bone marrow.
  • Bone marrow tests are usually required to diagnose AML.
  • Chemotherapy is the most common AML treatment. Stem cell transplant may also be an option.
  • The 5-year survival rate for childhood AML is about 70% in the U.S.
  • Cancer patients should continue to see their treatment center care team and/or a local primary care provider after cancer treatment.

Reviewed: August 2023

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