Sample Essay On Acute Myelogenous Leukemia

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Introduction
Acute myelogenous leukemia (AML) or acute myeloid leukemia is a cancerous disease that causes malignance in the cells found in the bone marrow and the blood (Andreeff). The word “acute” refers to the rapid progression of the disease. On the other hand, the term “myelogenous” is used to symbolize the effects of this disease on the myeloid cells (a white blood cells group). The development of these cells normally takes place into numerous mature blood cells types including platelets, white blood cells, and red blood cells (McCabe 63). In standard form, acute myelogenous leukemia (AML) can be described as “a disorder characterized by uncontrolled proliferation of primitive myeloid cells (blasts) ultimately replacing normal bone marrow elements and frequently resulting in hematopoietic insufficiency (granulocytopenia, thrombocytopenia, or anemia) with or without leukocytosis” (Ferri 619). Older adults are particularly affected by this hematopoietic, abnormal tissue-growing disease. It is worth-mentioning that even though several scientific advancements have been made to scrutinize and evaluate the epidemiologic, hereditary, and organic features of acute myelogenous leukemia, this disease continues to be incurable and deadly for the greater percentage of patients, principally older individuals (Rathnasabapathy & Lancet 469).

Pathophysiology

As far as the symptoms are concerned, patients show symptoms like bone pain, fever, fatigue, bruising, breath shortness, unusual blood loss, and infections. In the earliest development stages of acute myelogenous leukemia, the fundamental pathophysiology includes a maturational seizure of cells that are found in the bone marrow. Till date, the scientists are studying this arrest’s mechanism. However, the evaluation of a majority of cases indicates that there is an involvement of the activation of atypical genes through translocations of chromosomes and other abnormalities in the genes. The mentioned developmental seizure consequently results in two processes. The first process involves a marked decrease in normal blood cells’ production ultimately resulting in altering degrees of thrombocytopenia, neutropenia, and anemia. The second disease process involves the speedy propagation of these cells as well as a swift decline in their capability of undergoing apoptosis i.e. natural cell death (Karp 133). As a consequence, these cancerous cells accumulate in the blood, bone marrow, and several other body parts including the liver and spleen.

Clinical Presentation (Physical Findings)

Cytopenias effects usually make the patients to come to attention of the physicians. These may include manifestation of anemia along with fatigue or weakness. In some cases, manifestation of thrombocytopenia can be observed accompanied by occhyrnosis, bleeding, and petechiae. Fever and infections may also happen due to neutropenia. In many cases, bruises, pale skin, and petechiae is revealed through physical examinations. On the other hand, examinations of abdomen may also disclose peripheral lymphadenopathy and hepatosplenomegaly. Sometimes, leukostasis may also occur due to hyperleukocytosis (Ferri 619).

Etiology

There are a number of factors that are associated with the causation of acute myelogenous leukemia. These include precursor hematologic disorders, ancestral conditions or set of disease symptoms, and drug and environmental exposures. On the other hand, a majority of patients who have anew AML do not have any particular risk factor. Myelodysplastic syndrome (MDS) is the most ordinary risk factor for acute myelogenous leukemia present in patients as an antecedent hematologic disorder. It is actually a bone marrow disease with unidentified etiology and mostly occurs in elderly patients. Myelofibrosis and Aplastic Anemia are other hematologic disorders that are antecedent and incline patients towards the development of acute myelogenous leukemia. In addition, a number of congenital disorders including Down syndrome, Bloom syndrome, neurofibromatosis, Tuner Syndrome, Fancomi Anemia, and Klinefelter syndrome predispose patients to this acute condition (Ferri 619). Other risk factors include cigarette smoking, radiation exposure, drug and chemical exposure, and immunodeficiency states (Domino & Baldor 710). Drug exposure may include alkylating agents, ionizing radiation, benzene, and epipodophyllotoxins (Ferri 619).

Epidemiology

The diagnosis of acute myelogenous leukemia (AML) is more common in developed countries. In addition, it is more prevalent in white populations as compared to other populations. AML prevalence has a direct association with increasing age. Seventy years is the median age of the beginning of AML. Nevertheless, it must be mentioned that all age groups are affected by acute myelogenous leukemia. Moreover, its occurrence is more common in males as compared to females. This difference is more obvious in patients that are old. The reason is simple as men are more prone to develop Myelodysplastic syndrome (MDS) than women. When MDS reaches its advanced stages, it usually progressed into acute myelogenous leukemia. It is believed that AML prevails in men in higher degrees as they are exposed to drugs and other chemicals more often. It is significant to note that AML incidences are comparatively low. However, it is the “2nd most common type of leukemia in adults” (Domino & Baldor 710). Annual incidence is 2-4 cases per 100,000 individuals (Ferri 619).

Prognostic Factors

The prognosis of acute myelogenous leukemia is mostly reliable on a number of factors. The most advance factor is associated with increasing age as elderly patients are most commonly diagnosed with previous hematologic disorders. Their conditions are frequently accompanied by co-morbid medical ailments that do not make them capable of receiving full chemotherapy doses. Patients with acute myelogenous leukemia may die due to incompatibility of controlling the hemorrhage or infections. In general, this happens even after the usage of antibiotics and suitable blood product. There are certain factors on which the anticipated outcome for AML depends. If a person is less than 60 years of age, has no cancer or blood disorder history, or do not demonstrate chromosomal changes; there are higher chances for him to get cured of the cancerous conditions due to acute myelogenous leukemia.

Treatment and Medications

There are several workups to detect and diagnose acute myelogenous leukemia (AML) including blood tests, diagnostic imaging, biopsy and aspiration of bone marrow with the employment of the definitive diagnostic tests. In most cases, physicians also analyze genetic abnormalities in patients.
The cause of AML is still not known for many patients. Although there is no method for preventing it; risks of AML may be reduced through avoidance of chemicals exposure and quitting smoking (Wiernik 63). Acute myelogenous leukemia (AML) can also be treated through specific medications. However, some medications are reported to have causes severe depression of bone marrow in the affected patients. Therefore, it is important to use such agents through if specifically-trained physicians administer them. Moreover, blood banking that is both supportive and appropriate must be used to lessen the severity of acute myelogenous leukemia (AML).
The recent standard chemotherapy regimens are only beneficial for a small number of AML patients. Consequently, every AML patient must be examined to get entered into well-made clinical trials. In case of unavailability of clinical trial, standard therapy may be utilized for the treatment of the patient. Sometimes, the requirement of readmission occurs for managing the chemotherapy’s toxic effects.

Works Cited

Andreeff, Michael. Targeted Therapy of Acute Myeloid Leukemia. New York: Springer, 2014. Print.
Ferri, Fred F. Ferri's Clinical Advisor 2013: 5 Books in 1. London: Elsevier Health Sciences, 2012. Print.
Karp, Judith E. Acute Myelogenous Leukemia. Totowa, N.J.: Humana, 2007. Print.
McCabe, Paul C. Pediatric Disorders: Current Topics and Interventions for Educators. Thousand Oaks, Calif.: Corwin, 2010. Print.
Rathnasabapathy, R., and J. E, Lancet. "Management of Acute Myelogenous Leukemia in the Elderly." Cancer Control10.06 (2003): 469-77. Print.
Wiernik, Peter H. Adult Leukemias. Hamilton, Ont.: BC Decker, 2001. Print.