Understanding Your Phase of Acute Myeloid Leukemia (AML)

The way a cancer grows is called its pathophysiology. Most types of cancer are staged to communicate the size of the tumor and how far the cancer has spread. But leukemia rarely causes tumors. And because it is in your bone marrow and blood, it has already spread all over your body. With leukemia, doctors describe the extent of the cancer using the term phase. There are 3 phases: untreated or newly diagnosed AML, complete remission, or recurrent AML, which is also called relapse.

  • Untreated AML. During this phase, your doctor has just diagnosed your AML. Your complete blood count (CBC) is abnormal. You have more than 5% immature white blood cells, called blasts, in your bone marrow. And you have symptoms of leukemia, such as fatigue, fever, nosebleeds, or bruising. You have not been treated except to ease these symptoms. And it’s likely you won’t have symptoms.

  • Complete remission. You have received treatment for AML and all evidence of the disease has disappeared. During this phase, your CBC is normal, you have less than 5% blasts in your bone marrow, and you have no signs or symptoms of leukemia anywhere in your body.

  • Recurrent AML, also called relapse. During this phase, your CBC often becomes abnormal again, and you have at least 5% blasts in your bone marrow. Because initial treatment has failed, your doctor has to consider a new treatment plan to bring you back into remission.

Sometimes you will hear your doctor refer to your disease as either active or in remission. Active AML refers to untreated and recurrent phases. You may also hear the term minimal residual disease. During this phase, you still have some leukemia cells in your bone marrow. However, not enough are present for your doctor to see under a microscope during a routine exam. Your doctor would have to perform additional tests to find these cells.

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