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Acute myeloid leukemia (AML) - children

Acute myelogenous leukemia - children; AML - children; Acute granulocytic leukemia - children; Acute myeloblastic leukemia - children; Acute non-lymphocytic leukemia (ANLL) - children

Acute myeloid leukemia is a cancer of the white blood cells within the blood and bone marrow. Bone marrow is the soft tissue inside bones that generates all blood components including white blood cells. "Acute" means the cancer develops quickly and "myeloid" is the type of white cells that become cancerous.

Both adults and children can get acute myeloid leukemia (AML). This article is about AML in children.

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Causes

In children, AML is rare.

AML involves cells in the bone marrow that usually become white blood cells. These leukemia cells build up in the bone marrow and blood, leaving no space for healthy red and white blood cells and platelets to form. Because there are not enough healthy cells to do their jobs, children with AML are more likely to have:

• Anemia (low level of red blood cells)
• Increased risk for bleeding and bruising
• Infections

Most of the time, what causes AML is unknown. In children, some things can increase the risk of developing AML:

• Exposure to alcohol or tobacco smoke before birth
• A history of certain diseases, such as aplastic anemia
• Certain genetic disorders, such as Down syndrome, neurofibromatosis, and other rare syndromes
• Previous use of certain chemotherapy drugs such as cyclophosphamide
• Past treatment with radiation therapy

Having one or more risk factor does not mean your child will develop cancer. Most children who develop AML have no known risk factors.

Symptoms

Symptoms of AML include:

• Feeling weak or tired
• Bone or joint pain
• Frequent infections
• Easy bleeding or bruising
• Fever with or without an infection
• Night sweats
• Painless lumps in the neck, armpits, stomach, groin, or other parts of the body that may be blue or purple
• Pinpoint spots (petechiae) under the skin caused by bleeding
• Shortness of breath
• Loss of appetite and eating less food

Exams and Tests

The health care provider will perform the following exams and tests:

• Physical exam and health history
• Complete blood count (CBC) and other blood tests
• Blood chemistry study
• Chest x-ray
• Biopsies of the bone marrow, or lymph node
• A test to look for changes in the chromosomes in blood or bone marrow

Other tests may be done to determine the specific type of AML.

Treatment

Treatment for children with AML may include:

• Anticancer drugs (chemotherapy)
• Certain types of targeted therapy

Bone marrow transplant is used if the leukemia returns after treatment or doesn't respond well to initial therapy with chemotherapy. The process uses high doses of chemotherapy and sometimes radiation therapy and transfusion of bone marrow from a compatible donor.

Supportive care includes red blood cell and platelets (cells that help to stop bleeding) transfusions.

Your child's treatment team will explain the different options to you. You will want to take notes. Be sure to ask questions if you don't understand something.

Support Groups

Having a child with cancer can make you feel very alone. In a cancer support group, you can find people who are going through the same things you are. They can help you cope with your feelings. They can also help you find help or solutions for problems. Ask your health care team or staff at the cancer center to help you find a support group.

Outlook (Prognosis)

Cancer can come back at any time. But for most children, AML doesn't come back after being gone for 5 years. However, there is a wide range in outcomes for different subtypes of AML, and the disease might return.

Possible Complications

The leukemia cells can affect various organs in the body including:

• Brain
• Kidneys
• Lungs
• Skin
• Intestines

As a result of the treatment, it's common to experience:

• Fatigue
• Hair loss
• Weight loss
• Mouth sores
• Need for transfusions
• Infections requiring hospitalization
• Severe organ damage (very rarely)

When to Contact a Medical Professional

Contact your provider for an appointment right away if your child develops these symptoms:

• Persistent fever
• Easy bruising
• Shortness of breath
• Viral infection that doesn't resolve
• Prolonged fatigue
• Any other symptoms of AML

Prevention

Many childhood cancers can't be prevented. Most children who develop leukemia have no risk factors.

References

American Cancer Society website. What is childhood leukemia? www.cancer.org/cancer/leukemia-in-children/about/what-is-childhood-leukemia.html. Updated February 12, 2019. Accessed November 8, 2022.

Gruber TA, Rubnitz JE. Acute myeloid leukemia in children. In: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 62.

National Cancer Institute website. Childhood acute myeloid leukemia/other myeloid malignancies treatment (PDQ) - health professional version. www.cancer.gov/types/leukemia/hp/child-aml-treatment-pdq. Updated August 11, 2022. Accessed November 8, 2022.

Redner A, Kessel R. Acute myeloid leukemia. In: Fish JD, Lipton JM, Lanzkowsky P, eds. Lanzkowsky's Manual of Pediatric Hematology and Oncology. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 19.

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Review Date: 8/9/2022  

Reviewed By: Stergios Zacharoulis, MD, Associate Professor of Pediatric Oncology at Columbia University Irving Medical Center, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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