Symptoms
Increased night sweats, fever, weight loss, loss of appetite, performance slump and bone pain occur. In addition, anaemia occurs; its symptoms are paleness of the skin, a performance kink, rapid heartbeat (tachycardia) and rarely even tightness of the chest (angina pectoris). The suppressive growth of the degenerated cells results in a lack of “normal” defence cells.
The result is an increase in infections, e.g. of the lungs (e.g. pneumonia) or the renal pelvis (inflammation of the renal pelvis). Patients get fever more frequently.
Due to the lack of blood platelets (thrombocytopenia), there is increased bleeding, even after so-called minor traumas, such as during such everyday activities as brushing teeth. The consequences are then symptoms such as bleeding gums, nosebleeds and blood spitting. Symptoms such as gum enlargement (gingival hyperplasia) or double vision are rarely observed. The treating physician should also rule out an enlargement of the spleen and liver (hepatosplenomegaly). Leukaemia can therefore be recognized by many different signs.
Diagnosis
One of the first measures is the simple taking of blood samples. This is used to determine the cell counts of the blood platelets (thrombocytes), red blood cells (erythrocytes) and white blood cells (leukocytes). Since the group of leukocytes contains several different cell types (lymph cells, granulocytes), a so-called differential blood count is generated, which gives a precise analysis of these cells. In this way an absolute or relative decrease or increase of these cells can be detected. In the case of AML, for example, the above-mentioned examinations show a low number of red blood cells (anaemia) and a high number of white blood cells (leucocytosis).
Microscopic examination
A blood or bone marrow sample can be analysed with the help of a microscope. If so-called capers can be found in the examined cells, then AML is proven. These Auerbach rods resemble the smallest rods in the cell bodies.
Bone marrow puncture
A sample is taken for analysis, preferably from the basin. This sample is then stained (cytochemical staining) and further analysed. In addition, the sampled cells are examined with regard to their genetics in order to find irregularities (aberrations) in the cell genetics (cyto and molecular genetics). The findings of cytogenetics play a major role in the prognosis. A connection (translocation) between the gene carriers (chromosomes) 8 and 21 is rather positive for the prognosis, whereas the loss of chromosome 5, for example, has a very poor prognosis.
Therapy
Chemotherapy: The goal of this therapy is to destroy the leukemia cells with growth-inhibiting substances. The problem is that the substances do not only affect leukemia cells, but also all fast-growing cells in the body, e.g. other haematopoietic cells, hair cells (which is why the side effect of hair loss occurs during chemotherapy) and, particularly problematic, the germ cells (e.g. sperm cells).
Stem cell transplantation: There are two ways of stem cell donation: On the one hand, family members or foreign donors (allogeneic), if the tissue characteristics are suitable, stem cells can be taken from them and administered to the patient. From these stem cells “normal” healthy blood cells are then formed. However, high-dose chemotherapy must first be carried out in order to destroy as many degenerated cells as possible (for the principle of high-dose chemotherapy, see the general section on leukaemia).
On the other hand, healthy stem cells can be taken from the patient himself (autologous), if he is in the meantime in a stage of so-called full remission, i.e. when most of the degenerated cells have been destroyed, in order to administer them again when the disease returns. However, autologous stem cell transplantation is still in its infancy and is more likely to be used in clinical trials. Special drugs: The drug Gemtuzumab has shown very good results in the treatment of AML in recent years.
During chemotherapy, patients suffer from many, sometimes severe, side effects. In this situation, optimal care is of great importance and can alleviate many side effects:
- Nausea and vomiting: Nausea and vomiting is one of the main problems of many AML patients undergoing chemotherapy. In addition to medication, aromatic oils, chewing gum or fresh air can also provide relief.
- Prevention of infections Chemotherapy leads to a temporary suppression of the immune system. Affected patients therefore have virtually no body’s own defences and are particularly susceptible to infection. Strict hygiene measures are therefore the “A and O”.
Under certain circumstances, a so-called “reverse isolation” of the patient may even be necessary. This means that hospital staff or relatives may only enter the hospital room in special protective clothing. This is to reduce the number of potentially dangerous bacteria, viruses or fungi.
- Chemotherapy leads to a temporary suppression of the immune system. Affected patients therefore have virtually no body’s own defences and are particularly susceptible to infection. Strict hygiene measures are therefore the “A and O”.
Under certain circumstances, a so-called “reverse isolation” of the patient may even be necessary. This means that hospital staff or relatives may only enter the hospital room in special protective clothing. This is to reduce the number of potentially dangerous bacteria, viruses or fungi.
- Chemotherapy leads to a temporary suppression of the immune system. Affected patients therefore have virtually no body’s own defences and are particularly susceptible to infection. Strict hygiene measures are therefore the “A and O”.
Under certain circumstances, a so-called “reverse isolation” of the patient may even be necessary. This means that hospital staff or relatives may only enter the hospital room in special protective clothing. This is to reduce the number of potentially dangerous bacteria, viruses or fungi.
It is not uncommon for affected patients to seek alternative treatment for acute myeloid leukaemia. Especially in times of the Internet, a variety of apparently “gentler”, “alternative” or “natural” therapies can be found quickly. But can we believe these promises?
No, under no circumstances. Only chemotherapy and bone marrow transplantation represent an adequate and promising therapy! First and foremost, many patients turn to alternative “treatment options” for fear of the strong side effects of chemotherapy.
However, since AML is very aggressive, the treatment must unfortunately also be intensive and aggressive. Allegedly “gentle” or “alternative” treatments are therefore definitely not an option for serious medical professionals. In the worst case, patients die while trying to undergo alternative treatments.
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