Acute Myeloid Leukemia

• Acute myeloid leukemia (AML) is the most common type of blood cancer in adults. If untreated, this form of leukemia usually progresses quickly.
  
  
• Acute myeloid leukemia also goes by other names, including acute myelogenous leukemia, acute myeloblastic leukemia, acute granulocytic leukemia, acute monoblastic leukemia and acute nonlymphocytic leukemia.
  
  
• In a healthy person, bone marrow makes the blood stem cells that mature into infection-fighting white blood cells, oxygen-carrying red blood cells and blood-clotting platelets. When a person has AML, cells called myeloid stem cells usually develop instead into a type of immature white blood cell called myeloblasts, which never go on to become healthy, infection-fighting white blood cells.
  
  
• Sometimes in AML, too many stem cells also develop into abnormal red blood cells or platelets. When these abnormal, or leukemia, cells build up in the bone marrow and blood, there is less room for healthy white blood cells, red blood cells, and platelets, which may lead to infection, anemia, or easy bleeding. The leukemia cells can spread outside the blood to other parts of the body, including the brain, skin and gums.

Bone marrow transplant – Led by Nobel Prize recipient Dr. E. Donnall Thomas, Hutchinson Cancer researchers have transformed bone marrow transplantation into standard treatment for AML and other blood cancers. The procedure, as well as its sister treatment stem cell transplantation, is widely recognized as one of the greatest achievements in cancer treatment. Hundreds of thousands of lives have been saved thanks to bone marrow transplantation. Learn more »

New therapies for older adults – Our researchers, led by Dr. John Pagel, were the first to successfully combine low-intensity chemotherapy, targeted radiation and a stem cell transplant to successfully treat a group of older adult AML patients. The treatment is an improvement over high-dose radiation, which is an effective treatment for AML but causes significant transplant-related deaths among older-adult AML patients. Learn more »

Dr. Rainer Storb and colleagues have developed a radically different approach to stem cell transplantation known as the non-myeloablative or "mini" stem cell transplant. This treatment involves minimal doses of radiation that do not wipe out bone marrow, which makes it a viable procedure for older or other AML patients whose bodies cannot withstand the rigors of a conventional transplant. Studies show mini-transplant recipients are as likely to survive their cancers as full stem cell transplant recipients. Learn more »

Immunotherapy – Dr. Stanley Riddell and colleagues are investigating how the body’s own infection-fighting T-cells can be used to combat a variety of cancers. The approach, commonly known as immunotherapy, holds promise for treating several types of cancer, including chemotherapy-resistant ALL in children. Read more »

Hope for children with AML – Our research has discovered that a second stem cell transplant can improve the odds of curing aggressive AML in children whose cancer returns after a first transplant. Dr. Soheil Meshinchi and colleagues found that nearly half of the 25 children who received a second transplant were still alive and cancer-free 10 years after the study. Learn more »

Comfort during treatment – Our researchers are investigating ways to make AML treatment more bearable for patients. For example, they have shown that it is safe to discharge some patients from the hospital when their chemotherapy is complete. Traditionally patients are asked to remain in hospital for at least one month after treatment. We are now investigating whether the same principle applies to patients up to age 75.

The genetics of response and relapse – Our researchers are studying genetic mutations that can help predict response to AML therapy. Large cooperative studies, run through the Radich Lab, are looking to identify markers of resistance to help understand why patients do not respond to therapy, or respond but later relapse. Another study will investigate "clonal evolution" i.e. how some small clones of AML escape death from therapy and then expand to cause disease relapse. An understanding of how clonal selection occurs would allow physicians to develop more rational therapy that would use natural selection against AML, rather than working in its favor.