AML – What is it?
Leukaemia is a cancer of the blood – in AML the white blood cells and the bone marrow become cancerous.
Blood cells are made in your bone marrow, this is the soft inner part of your bones. Your body controls the making of the blood cells, it makes them when they are needed. Blood cells begin life as stem cells, these cells then develop into either red or white blood cells or platelets.
In AML the bone marrow makes too many white cells, which do not fully develop and consequently do not work properly. These immature white blood cells fill up the bone marrow and prevent it from making healthy blood cells, as a result of this bruising and anaemia can occur. White blood cells are used to fight infections, therefore children with leukaemia are highly likely to get infections. As the leukaemia cells multiply in the bone marrow the production of normal blood cells is reduced, children often complain of feeling tired and lethargic, whilst also experiencing aches and pains in their limbs.
One third of childhood cancers are leukaemia, with 400 new cases diagnosed in the UK every year. Less than a quarter of these are AML, however AML can and does affect children of any age and girls and boys are equally affected. There is no known cause of leukaemia.
Leukaemia is diagnosed through a series of tests, the first is usually a simple blood test which will show low white blood cells and the presence of leukaemia cells. A bone marrow biopsy will be done to check for abnormalities in the chromosomes of the leukaemia cells, and a lumbar puncture is also done to determine whether there is any leukaemia cells in the spinal fluid.
The first line of treatment for AML is a combination of chemotherapy, this aims to destroy the leukaemia to allow the bone marrow to work normally again. Usually the treatment consists of 4 cycles which mean 4-5 weeks in hospital and occasionally a few days at home before starting the next cycle. Side effects range from sickness, diarrhoea, vomiting, sore mouth, infections and hair loss. At the end of the first cycle of chemotherapy a bone marrow biopsy is repeated to check for leukaemia cells, if this is all clear then treatment continues. Should leukaemia still be present the combination of chemotherapy changes slightly, and a bone marrow transplant becomes a possibility.
What is a Donor Bone Marrow Transplant, also known as Donor Stem Cell Transplant?
A transplant is taking stem cells from another person (donor) and giving them to a person who needs them. The aim of this is to replace the bone marrow and immune system with that of the donors which will give you new healthy bone marrow and an immune system that can fight any remaining cancer cells.
High doses of chemotherapy are given and when the required amount has been given, the donor cells are given through a drip. The cells make their way to the bone marrow and then they settle into place (this is called engraftment). The cells then begin to make new blood cells.
Once your blood counts and side effects have improved you are allowed home. Recovery can take time and for the first few months you will have regular hospital appointments to monitor bloods and any side effects.
During the transplant you will be isolated in a room with minimal visitors, and the whole treatment will take between 6-10 weeks.
Every 20 minutes someone in the UK is told that they have a blood cancer such as leukaemia and for many people a bone marrow or blood stem cell transplant is the only option for them. The need cells from a healthy person – with the same tissue type – to replace and repair their own damaged cells. About 30% of people are able to find a suitable donor within their family, however the remaining 70% rely on a stranger to save their lives.
Anthony Nolan (anthonynolan.org) helps the 70% find those precious matches. They have over 500,000 adults on the register, but still need more donors. You can sign up to the Anthony Nolan register if you are between 16-30 and in good health, you will be sent a spit kit in the post so you can provide a sample. Visit their website to find out more.