What is Acute Myeloid Leukemia?
Acute Myeloid Leukemia (AML) is a complex blood cancer that begins in the bone marrow, where blood cells are produced. To understand its causes, we need to first recognize how it develops: AML occurs when young blood cells called myeloid cells fail to mature properly and instead grow uncontrollably, interfering with normal blood cell production.
The development of AML is not typically attributed to a single cause, but rather results from a combination of factors that damage DNA and disrupt normal blood cell development. Understanding these various factors can help us better comprehend who might be at risk and why the disease develops.
Genetic Factors
Inherited Genetic Conditions
Some people are born with genetic changes that increase their risk of developing AML. These inherited conditions include:
Down syndrome significantly increases the risk of developing AML, particularly in children. The additional chromosome 21 affects how blood cells develop and mature.
Fanconi anemia, a rare inherited condition, impairs the body's ability to repair damaged DNA, leading to a higher risk of developing AML.
Acquired Genetic Changes
Most cases of AML develop from mutations acquired during a person's lifetime either through an exposure to an agent, such as tobacco or benzene or random chance. These changes can affect:
Proto-oncogenes
Genes that normally help cells grow become overactive
Tumor Suppressor Genes
Genes that usually control cell growth become inactive
Environmental and Lifestyle Factors
Benzene Exposure
Certain chemical exposures can damage DNA and increase AML risk:
Benzene exposure, commonly found in the petroleum industry and cigarette smoke, is strongly linked to AML development. Workers in industries using benzene should follow safety protocols carefully, these include pipefitters, boilermakers, tankerman, and any other individual that works in the petrochemical industry with or around benzene. All of these individuals are susceptible to exposure to benzene and subsequent AML caused by benzene exposure.
Radiation Exposure
High-energy radiation can damage DNA in bone marrow cells:
Both high-dose radiation therapy for cancer treatment and environmental radiation exposure can increase AML risk. The risk is dose-dependent, meaning higher exposure levels generally correspond to greater risk.
Previous Medical Treatments
Certain medical treatments can increase the risk of developing AML:
Chemotherapy
Previous treatment with certain chemotherapy drugs, particularly alkylating agents and topoisomerase inhibitors, can lead to treatment-related AML. This typically occurs within 5-10 years of treatment.
Other Blood Disorders
People with certain blood disorders, such as myelodysplastic syndrome or myeloproliferative disorders, have an increased risk of developing AML as their condition progresses.
Reducing Your Risk
While some risk factors for AML cannot be controlled, there are steps you can take to reduce your risk:
Avoid tobacco use and exposure to secondhand smoke
Follow safety protocols when working with chemicals like benzene
Maintain regular medical check-ups, especially if you have risk factors
When to Seek Medical Attention
If you have risk factors for AML, be aware of early warning signs:
Unexplained fatigue and weakness
Frequent infections or fever
Easy bruising or bleeding