Acute Monocytic Leukemia (AML)

What is it? Leukemia is a cancer of the blood-forming tissues of the bone marrow. Within the bone marrow, blood cells all start out as stem cells. They mature and become red cells, white cells, or platelets. Leukemia, which means "white blood," is a cancer of the white cells. White cells, or leukocytes are infection fighters. There are three main types of leukocytes: monocytes, lymphocytes, and granulocytes. AML affects only the white cells that are monocytes.

What causes it? As with other childhood cancers, there is no known cause for leukemia. Scientists believe that children with a deficient immune system may be at an increased risk for leukemia, and significant exposure to radiation is an environmental risk factor that can lead to this disease. But most children who develop leukemia do not have any known risk factor or cause for it.

What are the symptoms? The symptoms for leukemia often start out like many common illnesses with fatigue and fevers. What may prompt a trip to the doctor are infections that do not get better with antibiotics, abnormal bruising or bleeding, swollen lymph glands,excessive fatigue, and bone or joint pain.

How is it diagnosed? Leukemia can only be diagnosed with a full evaluation of the blood and bone marrow. If the doctor suspects leukemia after a preliminary physical examination, blood tests will be ordered. If the blood tests show anemia and other suspicious changes in the blood, a bone marrow test will be done. The sample cells from the marrow will be examined under a microscope to determine just what cells are affected and what kind of cancer is involved.

What is the treatment? The initial treatment (induction) uses a combination of chemotherapy drugs to achieve a remission (ridding the bone marrow of the visible leukemic cells). Following this is the consolidation treatment which involves very intense chemotherapy to try to eliminate any cells that might be "hiding" in the body. Part of the treatment for AML also involves antibiotics, nutritional support, and transfusions when necessary because the doses of chemotherapy are so toxic that patients require extra supportive care.

What is the impact on school participation? Due to very intense chemotherapy treatment, side effects such as susceptibility to infections, nausea, fatigue, and anemia may make it difficult for any patient to maintain a regular school schedule. Setting up "intermittent" home tutoring is a good way to help the student keep up with work on days of feeling okay. Helping her or him catch up will ease the work load and psychological impact later. If the student does feel well enough to return to school, there will still be days of feeling under par and absences for treatments. How the student feels the day or two after each chemotherapy will be a very individual thing. Teachers will need to be flexible and creative with assignments to help the student keep up enough to move along with the class. The important thing is to allow the student to continue to feel a part of the class and to view school as a positive thing during a very difficult time.

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