Acute myeloid leukemia (AML) is the most common type of acute leukemia that develops in adults, according to the National Cancer Institute (NCI). It also makes up about 15% to 20% of acute leukemias in children.

The cancer can develop quickly and require aggressive treatment. Leukemias tend to develop slower.

AML develops in the blood-producing cells in your bone marrow and quickly moves to your blood. It can spread to other parts of your body, such as your:

  • There are lymph nodes.
  • The person has a body part called the liver.
  • The spleen is large.
  • testicles
  • The brain and spine have fluid and nerves.

It’s less common for AML to spread to your spinal fluid and central nervous system (CNS) than another type of cancer called acute lymphocytic leukemia (ALL).

Acute myeloid leukemia affects your central nervous system and spine, and we take a closer look at how it affects you.

Cancer cells spreading to the spinal fluid and CNS is reported in about 3 percent of people with AML. Although, some researchers think this might be an underestimation. CNS involvement seems to be more common in children.

Research involving European pediatric AML study groups reported CNS involvement affecting 6% to 29% of children with AML.

In a 2017 study, researchers found that CNS involvement was more common in people with relapsed AML than in newly diagnosed AML. In a group of 3,261 people with AML, 0.6% had CNS involvement at initial diagnosis, while 2.9% had it at relapse.

Researchers are trying to understand how leukemia cells reach your brain.

In a 2018 study, researchers found evidence in mice that leukemia cells grasp proteins on the outside of blood vessels and ride them from bone marrow to your spinal fluid.

Risk factors for CNS involvement

Risk factors associated with the development of CNS involvement include:

  • White blood cells and lactate dehydrogenase levels are high.
  • There are two problems with the chromosomes 16 and 11.
  • Acute myelomonocytic leukemia or acute monocytic leukemia are subcategories of the disease.
  • Younger age.

AML in your spinal fluid or other parts of your CNS usually doesn’t cause symptoms. If symptoms are present, they depend on where cancer cells are found. They can include:

If your cranial nerves are affected, you may have a problem.

In rare cases, the hypothalamus can be changed in a way that causes sudden onset of Obesity.

More typical symptoms of AML include:

To check to see if leukemia has spread to your cerebrospinal fluid, your doctor can test your fluid using a procedure called a lumbar puncture or spinal tap.

“A small amount of your back’s fluid is removed with a needle. The procedure should not cause much pain.”

A lumbar tap isn’t typically used for AML in adults unless you have symptoms that suggest that cancer has spread to your spinal fluid. It’s part of routine evaluation for children.

Treatment for AML with CNS involvement depends on factors.

  • Your age.
  • Your overall health.
  • The subcategory ofAML you have.
  • The degree and location of the involvement of the CNS.
  • Did you receive previous cancer treatment?

Induction therapy

An initial round of chemotherapy called induction chemotherapy is used to kill leukemia cells in your bone marrow. Induction therapy often includes a combination of cytarabine and an anthracycline drug such as daunorubicin or idarubicin.

Some people with certain genetic defects may be able to receive targeted therapy.

Consolidation therapy with stem cell transplant

If you achieve remission after the first round of treatment, you will receive a second round of treatment to kill any remaining cells. A high dose cytarabine is a regimen that is included in consolidation therapy.

You may also receive a bone marrow transplant during this stage of treatment if you’re eligible.

People who received targeted therapy may continue to receive them.

Intrathecal chemotherapy

If doctors find evidence of CNS involvement after a lumbar puncture, you’ll likely receive intrathecal chemotherapy, a procedure where chemotherapy drugs are injected directly into your spinal fluid. Usually, the drugs methotrexate or cytarabine are used.

Intrathecal chemotherapy may also be combined with radiation therapy.

CNS involvement is associated with a poorer outlook in people with AML. Research suggests that about half of people with CNS involvement live less than about 3 months, and the reported 5-year overall survival rate is 11%.

Despite a generally poor outlook, treatment options are improving, and the survival rate for AML is likely to improve in the future. Since 1975, the overall 5-year relative survival rate has improved from 5.5% to 30.3%, according to the NCI.

In a 2021 study, researchers found no significant difference in survival between people with newly diagnosed AML with or without CNS involvement.

People frequently ask about the disease in the spine.

How fast does AML spread?

Leukemias are classified as acute or chronic. Acute leukemias like AML tend to spread quickly and require aggressive treatment. Symptoms of AML tend to develop over a few weeks and continue to get worse.

Is a bone marrow test similar to a lumbar puncture?

A bone marrow biopsy involves having a small amount of bone marrow taken from one of your bones with a long, thin needle. Often the sample is taken from your pelvic bone.

A lumbar puncture involves inserting a needle into your lower spine. The needle is inserted into the subarachnoid space where spinal fluid circulates between the protective layers of your spinal cord.

Can AML start in the spinal fluid or does it typically spread there from bone marrow or peripheral blood?

Cells that produce blood cells are the start of the disease. Your bone marrow is where most of the cells that make blood cells are located. Abnormal blood cells can reach your spine fluid.

Acute myeloid leukemia can spread to your central nervous system. Children are more likely to be involved in the CNS than adults. The leukemia ALL seems to spread to the central nervous system more frequently than the leukemiaAML.

Symptoms of the disease that has spread to the central nervous system are not caused by it. When the involvement of the central nervous system is suspected, a lumbar puncture is performed in adults.

If you have any symptoms that suggest that the cancer has spread to your central nervous system, it is important to let your doctor know. There are unexplained headaches, nausea, or vomiting.