Acute myeloid leukemia (AML) is a type of blood cancer. While this typically starts in the myeloid cells of the bone marrow (soft inner part of bones) that normally turn into white blood cells, in some cases AML can also start from other blood-forming cells. The disease usually originates in the bone marrow and then moves into the blood. It can also spread to the lymph nodes, liver, spleen, brain spinal cord and testicles. The bone marrow cells formed in AML cases are immature and abnormal and they also multiply rapidly. These leukemic cells cannot carry out the functions of normal white blood cells which is mainly to resist infections.
Even though AML is the amongst the common type of leukemia, it only accounts for about 1% of total cancer cases. This disease usually occurs in the elderly and is rarely seen in those below the age of forty five. The average age of occurrence is about seventy years. Men are slightly more likely to develop the disease than women.
The exact cause of Acute Myeloid Leukemia (AML) disease is not clear. Certain mutations or changes in the genes are thought to be the reason. But what exactly causes these changes is again not fully understood.
There are certain factors which are known to increase the risk of getting the disease. These include:
oExposure to chemicals like benzene, formaldehyde etc
AML is hard to diagnose initially as the symptoms are very common with many other common ailments like flu. These symptoms include fatigue, fever, loss of appetite, sweating in the night while sleeping.
The most common mode of treatment for Acute Myeloid Leukemia (AML) is chemotherapy. Other treatments include targeted therapy and bone marrow transplant. The treatment is decided according to the sub-type of the disease.
The treatment of AML is divided into two phases. They are:
1.Phase 1 - Remission induction therapy: Aim of this treatment phase is to destroy and eliminate the leukemic cells from the blood and bone marrow. In this phase as much of the leukemic cells as possible are destroyed by using chemotherapeutic drugs.
2.Phase 2: Consolidation therapy-This phase of treatment is also called as post-remission therapy, maintenance therapy or intensification. The remaining leukemic cells present in the blood and bone marrow is destroyed during this phase of treatment. This helps to prevent the chances of a relapse.
The standard treatments used in these phases are:
Chemotherapy: This is the most preferred mode of treatment during remission induction therapy. It may also be used for consolidation therapy. Chemotherapy uses certain drugs to kill cancer cells. Chemotherapy drugs are given as pills or intravenous infusions. The treatment is given in cycles with a period of rest in between. The treatment can cause certain transient undesirable side effects.
Targeted therapy: Targeted therapy drugs differ from chemotherapy in the way the drugs kill the cells. These drugs can identify and kill cancerous cells without harming normal cells.
Radiation therapy: Here high energy X-rays and/or types of radiations are used to target and kill cancer cells. External radiation therapy which uses a machine like an X-ray to send radiations and kill cancer cells. Internal radiation therapy involves infusion of radioactive material into the body near cancer cells through needles, catheter tubes etc. External radiation therapy is more commonly used in AML treatment.
Bone Marrow Transplant: Bone marrow transplant (BMT) is effective in treating certain types of AML. Prior to a bone marrow transplant, the diseased bone marrow is removed through chemotherapy and radiation. A healthy bone marrow sourced from a donor (Allogenic BMT) or self(Autologous BMT) is then transferred into the bone marrow spaces. This healthy bone marrow then starts producing normal blood cells. A bone marrow transplant procedure is a complex one and requires an extended stay in the hospital. Anti-transplant rejection medicines will have to be taken for the rest of one’s life. Since these medicines tend to decrease the immunity of the body, care must be taken to avoid infections. Allogenic BMT from a donor is the preferred option in the treatment of AML. Chances of success are high when the donor is closely related by blood like a sibling or parent.
You can see a list of top hospitals specialised in treating AML(Acute Myeloid Leukemia) on this page.
Choosing the right hospital is extremely vital for treatment of critical cases like Leukemia. AML is a comparatively rare form of cancer even though it is one of the most common types of leukemia. Hence, past experience in treating AML is of utmost importance. The team of doctors should include experienced hematologist and medical oncologists.
Some of the other key factors for choosing the hospital include the quality standards, accreditation (ideally by Joint Commission International or JCI) and the facilities in the hospital.
If you are travelling from outside India, you also need to ensure that hospital has good experience in dealing with international patients. It is a good idea to check the travel options to the city. Most of the major Indian cities are indeed well connected by air with all major world cities.
Acute Myeloid Leukemia (or AML) is a rare type of cancer affecting the blood cells. As this disease spreads quickly through blood, timely treatment is key to survival.
AML treatment is typically in 2 phases with phase 1 remission induction therapy and phase 2 consolidation therapy. Aim of remission induction therapy is to destroy all cancerous cells in blood and bone marrow. Consolidation therapy is done after remission and objective here is to destroy any remaining cancel cells.
Remission means there are less than 5% of abnormal cells and blood cell counts are normal. This means the treatment is successful. On the other hand, the patient is said to have relapsed if there are more than 5% of abnormal cells after treatment.
Survival rate depends on some key parameters like
·Subtype of AML
·Presence of any other blood disorders
Survival rate after 5 years for AML is around 25% for people older than 20 years. The survival rate goes up to 67% for people less than 20 years.
Around 65-70% of the people achieve remission after phase 1 remission induction therapy for AML types other than Acute promyelocytic leukemia (APL). With APL, about 90% of the people go into remission after phase 1 treatment.
In cases where allogenic Bone marrow transplant (BMT) done in first remission, 5 year disease free rate is between 30-50%. The first 2 years after BMT is important. In patients where there is no relapse within 2 years of BMT, the long term disease free rate is very good at around 80%.
The cost depends on the mode and duration of treatment. The cost ranges from 15,000 to 50,000 USD for treatment. This would cover chemotherapy and Bone marrow transplant if required. The overall duration of treatment will be around 2-3 months with about 15-20 days of hospitalisation. In addition to the cost mentioned above, you will need to plan for travel, stay in India (outside of the hospitalisation period) and other occasional living expenses. Hotels (approved by the hospitals based on infection control facilities) and guest houses are available starting from 20 USD per day.
Acute Myeloid Leukemia (AML) treatment is generally 2 fold starting remission therapy followed by consolidation therapy. The standard treatment modes are Chemotherapy ,Targeted therapy, radiation therapy and Bone marrow Transplant.
There will be an initial evaluation which would cost around 1,000 to 1,500 USD generally. Remission chemotherapy cost would range from 10,000 to 15,000 USD. This cost would depend on the number of cycles of chemotherapy planned, type of medicine used and the hospital. Allogenic Bone marrow transplant (BMT) with a family donor(matched) would cost between 35,000 to 40,000 USD. Autologous transplant (where the bone marrow is taken from the patient’s body itself) will be much cheaper and would cost around 20,000 USD. However, allogenic BMT is considered to be more effective for AML treatment and so doctors would usually prescribe allogenic BMT. In case there is no matching donor within the first line relatives (siblings, children, parents), bone marrow can be sourced through global donor registries. This is more expansive and cost upwards of 50,000 USD in most cases.
Success stories from people who underwent treatment for Acute myeloid leukemia
Aida Ismail, AUSTRALIA
"My uncle from Ethiopia was diagnosed with Acute Myeloid Leukemia and needed urgent treatment overseas...After searching online, I reached out to a number of hospitals. INDHEAL responded quickly and provided all the information I needed to pick a hospital in India. I couldn’t have gotten my uncle the treatment without INDHEAL."