Acute myeloid leukemia is a cancer of the blood and bone marrow. Bone marrow is the soft tissue inside bones that helps form blood cells. Acute means the cancer develops quickly.
Both adults and children can get acute myeloid leukemia (AML). This article is about AML in children.
In children, AML is very rare.
AML involves cells in the bone marrow that usually become white blood cells. These leukemia cells build up in the bone marrow and blood, leaving no space for healthy red and white blood cells and platelets to form. Because there are not enough healthy cells to do their jobs, children with AML are more likely to have:
- Increased risk for bleeding and bruising
Most of the time, what causes AML is unknown. In children, some things can increase the risk of developing AML:
- Exposure to alcohol or tobacco smoke before birth
- A history of certain diseases, such as aplastic anemia
- Certain genetic disorders, such as Down syndrome
- Past treatment with some drugs used to treat cancer
- Past treatment with radiation therapy
Having one or more risk factor does not mean your child will develop cancer. Most children who develop AML have no known risk factors.
Symptoms of AML include:
- Bone or joint pain
- Frequent infections
- Easy bleeding or bruising
- Feeling weak or tired
- Fever with or without an infection
- Night sweats
- Painless lumps in the neck, armpits, stomach, groin, or other parts of the body that may be blue or purple
- Pinpoint spots under the skin caused by bleeding
- Shortness of breath
- Loss of appetite and eating less food
Exams and Tests
The health care provider will perform the following exams and tests:
- Physical exam and health history
- Complete blood count (CBC) and other blood tests
- Blood chemistry study
- Chest x-ray
- Biopsies of the bone marrow, tumor, or lymph node
- A test to look for changes in the chromosomes in blood or bone marrow
Other tests may be done to determine the specific type of AML.
Treatment for children with AML may include:
- Anticancer drugs (chemotherapy)
- Radiation therapy (rarely)
- Certain types of targeted therapy
- Blood transfusions may be given to help treat anemia
The provider may suggest a bone marrow transplant. A transplant is usually not done until the AML is in remission from initial chemotherapy. Remission means no significant signs of cancer can be found in an exam or with testing. A transplant can improve the chances of a cure and long-term survival for some children.
Your child's treatment team will explain the different options to you. You may want to take notes. Be sure to ask questions if you don't understand something.
Having a child with cancer can make you feel very alone. In a cancer support group, you can find people who are going through the same things you are. They can help you cope with your feelings. They can also help you find help or solutions for problems. Ask your health care team or staff at the cancer center to help you find a support group.
Cancer can come back at any time. But with AML, it is very unlikely to come back after being gone for 5 years.
The leukemia cells can spread from the blood to other parts of the body, such as:
- Spinal fluid
The cancer cells can also form a solid tumor in the body.
When to Contact a Medical Professional
Call for an appointment with your provider right away if your child develops any symptoms of AML.
Also, see your provider if your child has AML and a fever or other signs of infection that will not go away.
Many childhood cancers can't be prevented. Most children who develop leukemia have no risk factors.
Acute myelogenous leukemia - children; AML - children; Acute granulocytic leukemia - children; Acute myeloblastic leukemia - children; Acute non-lymphocytic leukemia (ANLL) - children
American Cancer Society website. What is childhood leukemia? www.cancer.org/cancer/leukemia-in-children/about/what-is-childhood-leukemia.html. Updated February 12, 2019. Accessed October 6, 2020.
Gruber TA, Rubnitz JE. Acute myeloid leukemia in children. In: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 62.
National Cancer Institute website. Childhood acute myeloid leukemia/other myeloid malignancies treatment (PDQ) - health professional version. www.cancer.gov/types/leukemia/hp/child-aml-treatment-pdq. Updated August 20, 2020. Accessed October 6, 2020.
Redner A, Kessel R. Acute myeloid leukemia. In: Lanzkowsky P, Lipton JM, Fish JD, eds. Lanzkowsky's Manual of Pediatric Hematology and Oncology. 6th ed. Philadelphia, PA: Elsevier; 2016:chap 19.
Review Date 7/21/2020
Updated by: Adam S. Levy, MD, Division of Pediatric Hematology/Oncology, The Children's Hospital at Montefiore, Bronx, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.