Acute megakaryoblastic leukaemia (AMKL)

Acute megakaryoblastic leukaemia (AMKL) is a fast-growing blood cancer. It is a rare type of acute myeloid leukaemia (AML). AMKL develops when blood-forming cells called megakaryocytes divide and mature uncontrollably. They build up in your bone marrow and stop it making enough healthy blood cells.

AMKL is very rare. It can affect people of any age.

• Children with Down’s syndrome have a higher chance of getting AMKL than other people. But it is still very rare.
• AMKL can also affect children without Down’s syndrome, but this is less likely.
• AMKL is even rarer in adults.

People with AMKL have genetic changes in their blood-forming cells. These make the cells grow out of control. The genetic changes usually happen by chance. They cannot usually be passed on to other people in your family.

We do not know the exact cause of AMKL. But it is not because of anything you have or have not done.

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The signs and symptoms of AMKL might include:

• Infections
• Low red blood cell count (anaemia)
• Bruising or bleeding
• A swollen spleen or liver
• Swollen lymph nodes
• Extreme tiredness
• Night sweats
• Pale skin (this may look different on black or brown skin)

AMKL is usually diagnosed from blood tests and bone marrow tests.

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Treatment for AMKL varies from person to person. There is no standard approach and different doctors might use different options. Your haematology team will suggest the most suitable treatment option for you. They should explain what it is, how you have it and what you can expect from it.

• Children with Down’s syndrome are likely to have a combination of chemotherapy medicines. They often respond well to chemotherapy and may not need further treatment.
• Adults and children without Down’s syndrome are also likely to have chemotherapy as their first treatment. After chemotherapy they may also need a stem cell transplant.
• Your team might suggest treatment as part of a clinical trial, if there is one suitable for you. This could let you access treatments that would not otherwise be available. It is your choice whether or not to take part.

The outcome of AMKL varies from person to person. Your medical team are best placed to discuss what they expect for you.

It can be hard dealing with treatment and its side effects. Don’t be afraid to ask for help from family, friends, your medical team or Leukaemia Care.

Chemotherapy for AMKL

• Chemotherapy for AMKL happens in cycles or phases.
• You usually have a combination of different chemotherapy medicines. This varies from person to person. Your team will tell you what medicines they recommend for you.
• You have different medicines on different days, with some rest days between treatment. Your team can tell you what you’ll have on each day.
• You usually stay in hospital to have treatment. Your team can give you an idea of how long you might need to stay in.

Stem cell transplant

• A stem cell transplant replaces damaged or abnormal blood-forming cells in your bone marrow with healthy ones. These usually come from a donor. Sometimes this is a family member.
• If you need a stem cell transplant, your team will explain what it involves. It is an intensive form of treatment and it is not suitable for everyone.
• You usually need to stay in hospital for several weeks to have it.

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