Acute myeloid leukemia

What it is

Acute myeloid leukemia — AML — is a cancer of the blood and the bone marrow, the soft center of our bones where blood is made. In a healthy body, the marrow makes red cells that carry oxygen, white cells that fight infection, and platelets that stop bleeding. In AML, the marrow starts turning out huge numbers of abnormal, immature cells that never grow up and never do their job.

Those cells multiply fast and crowd out the healthy ones. That is what “acute” means here: it moves quickly, and it has to be treated quickly. As the normal blood cells fall away, a person grows exhausted, bruises and bleeds easily, and catches infections a healthy body would shrug off.

How it is found

AML often announces itself quietly — weeks of feeling worn down, low fevers, bruises with no clear cause, an infection that will not clear. A simple blood test is usually the first sign something is wrong.

The diagnosis is confirmed with a bone marrow biopsy, where a small sample is drawn from inside the bone and examined. Doctors then look deeper still, at the chromosomes and genes inside the leukemia cells. Those details matter enormously: they tell the team how aggressive the disease is likely to be, and which treatments it is most likely to answer.

How it is fought

Treatment usually begins almost at once, and it is hard. The first phase, called induction, is a course of strong chemotherapy meant to drive the leukemia into remission — to clear it out of the blood and marrow. It often means several weeks in the hospital, at the time the body is most fragile.

Reaching remission is not the end. Because even a few surviving cells can bring the disease back, remission is followed by more treatment to keep it away — further chemotherapy, and for many people a stem cell transplant, sometimes called a bone marrow transplant, in which healthy blood-forming cells from a donor are used to rebuild an entire new immune system. For higher-risk disease it offers the best chance of a lasting cure, and it asks an enormous amount of the person going through it.

Not every path looks the same. Newer targeted medicines can go after specific genetic faults in the leukemia, and gentler drug combinations make treatment possible for people who cannot withstand the most intensive chemotherapy. Clinical trials open doors to options that are not yet standard. Through all of it, supportive care — transfusions of blood and platelets, antibiotics, careful nursing — keeps a person going while the treatment does its work.

The toll it takes

The fight is measured in months, not days, and much of it is spent in isolation. Treatment deliberately empties out the immune system, so patients are kept apart from the ordinary world of crowds and germs at exactly the moment they most need the people they love. It is grueling for the patient, and for the family and friends who sit with them through it.

Small human things come to matter more than they should have to. A window. A visitor. Something to do with your hands on a long afternoon in a hospital room. Debbie found painting in one of those rooms, and it carried her.

How you can help

Two of the most powerful things anyone can do cost nothing but a little time. Giving blood and platelets keeps patients alive through the weeks when their own marrow cannot — the entire supply comes from volunteers. And joining the bone marrow registry can one day make you the match that gives a stranger a transplant, and a chance.

Debbie's foundation grew straight out of her own treatment: it puts watercolor supplies into the hands of leukemia and transplant patients, on the wards where they are being cared for.

Learn moreGive in her memory

Debbie's own journey through all of this — from the first signs to her last years — will be told here, in her family's words, before long.

This page is general information, written to help — not medical advice. Every person's illness is different, and every decision about treatment belongs with their own doctors.