Acute Myeloid Leukemia: Complications

The following are the major diseases or complications that may be contributed to by acute myeloid leukemia (AML): Blood, blood-forming organs – Immune system (D50-D90).

Cardiovascular system (I00-I99)

  • Cardiomyopathy (myocardial disease) due to cardiotoxicity (cardiac or myocardial damage) of therapy – In one study, cardiotoxicity (= left ventricular systolic dysfunction ≥ 2nd degree (decrease in left ventricular pump function, i.e., left ventricle)) occurred in 12% of patients during 5 years of follow-up; in 71% of cases, cardiotoxicity occurred during therapy. Cardiotoxicity affected both event-free survival (hazard ratio [HR] 1.6; p = 0.004) and overall survival (HR 1.6; p = 0.005).
  • Thrombosis (occlusion of a vein by a blood clot), venous and/or arterial – Occurred mainly during induction chemotherapy; 8.7% of younger patients (4.7% venous, 4.0% arterial). 2.9% pulmonary embolism, 1.4% leg vein thrombosis, and 0.4% thrombosis in arms; arterial thrombosis → 1.4% myocardial infarction (heart attack) or acute coronary event, 1.4% ischemic apoplexy (stroke), 0.4% transient ischemic attack (TIA; sudden circulatory disturbance of the brain leading to neurological dysfunction that resolves within 24 hours), 0.7% other arterial thrombotic events; laboratory diagnostics: D-dimer

Infectious and parasitic diseases (A00-B99).

  • Infections of all kinds
  • Sepsis (blood poisoning)

Neoplasms – tumor diseases (C00-D48)

  • Recurrence – recurrence of the disease.
  • Malignant melanoma (primary melanoma) (6.4 times standardized incidence rate as ratio of observed to expected tumor incidence)
  • Myelosarcoma (synonyms: granulocytic sarcoma, extramedullary myeloid tumor, or chloroma); occurs mediastinally (2-5% of patients with AML develop such an extramedullary manifestation)

Genitourinary system (kidneys, urinary tract – reproductive organs) (N00-N99).

  • Renal insufficiency/Uremia – renal weakness or failure/occurrence of urinary substances in the blood above normal values.

Prognostic factors

  • The prognosis of patients with acute myeloid leukemia (AML) depends on the mutations that “survived” chemotherapy: Leukemia-associated mutations after chemotherapy shortened patient survival from 42.2 to 10.5 months.Note: Approximately 20% of all patients with AML are cured by initial chemotherapy, meaning they do not require further therapy. Another 50% have relapse after initial remission (proportion of blasts < 5%).