Classification and prognosis for AML
Working out the subtype of acute myeloid leukaemia (AML) is called classification. It helps doctors to plan treatment and work out prognosis. AML is divided into more than 20 different subtypes according to the type of myeloid cell that has become abnormal and whether:
- there are particular genetic changes in the leukaemia cells
- the leukaemia started from a blood disorder called myelodysplasia
- more than one type of blood cell has abnormal changes.
One subtype of AML develops from immature myeloid cells called promyelocytes. This is called acute promyelocytic leukaemia (APML). It is treated differently to other forms of AML.
Prognosis means the expected outcome of a disease. You may wish to discuss your prognosis with your doctor. It is not possible for anyone to predict the exact course of the disease, but your doctor can give you an idea about the issues that affect people with your type of AML.
Important factors in assessing your prognosis include:
- test results
- the rate and extent of leukaemia cell growth
- how well you respond to treatment
- other factors such as age, fitness and medical history.
For many people, treatment can reduce the signs and symptoms of acute leukaemia for years. This is known as remission.
Leukaemia sometimes becomes active again (recurs) after a period of remission because a small number of cancer cells were left behind. This is known as minimal residual disease (MRD). Doctors may measure a person’s MRD to determine risk of recurrence and the need for more treatment. Techniques used to find MRD include:
- immunophenotyping – tests for markers or signals on the surface of leukaemia cells
- PCR – looks for genetic changes in cells.
Dr Anoop Enjeti, Senior Staff Specialist Haematologist, Calvary Mater Newcastle, and Conjoint Senior Lecturer, The University of Newcastle; Ray Araullo, Deputy Head, Social Work Department, Royal North Shore Hospital; Shehaan Fernando, Consumer; Narelle Greentree, Clinical Nurse Specialist, Hunter Haematology Unit, Calvary Mater Newcastle; Yvonne King, 13 11 20 Consultant, Cancer Council NSW; Karen Maddock, Haematology Clinical Nurse Consultant, Westmead Hospital; Melanie Sexton, Consumer; Dr Jonathan Sillar, Haematology Registrar, Calvary Mater Newcastle, and Conjoint Fellow, The University of Newcastle.
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