STEP 1: Prevention and early detection
This step outlines recommendations for the prevention and early detection of AML. Except in uncommon specific circumstances (see section 1.2), the principal recommendations for most people are the same as for cancer in general.
Evidence shows that not smoking, avoiding or limiting alcohol intake, eating a healthy diet, maintaining a healthy body weight, being physically active, being sun smart and avoiding exposure to oncoviruses or carcinogens may help reduce cancer risk (Cancer Council Australia 2018).
The causes of AML are not fully understood, and there is currently no clear prevention strategy.
Most people have no identifiable risk factors. It is possible for AML to run in families but is uncommon. However, in a small proportion of patients, risk factors can be identified. Currently known risk factors include:
- advanced age
- prior chemotherapy, radiation therapy or high-dose radiation exposure
- a known previous haematological disorder with a risk of leukaemic transformation, such as myelodysplastic syndromes, myeloproliferative diseases or congenital neutropenic syndrome
- known predisposing genetic disorders such as Down syndrome, Trisomy 8, Bloom syndrome, Ataxia-telangiectasia, Diamond-Blackfan anaemia, Shwachman-Diamond syndromes, Li-Fraumeni syndrome, neurofibromatosis type 1, severe congenital neutropenia or Fanconi anaemia
- obesity
- tobacco smoking
- having a first-degree relative with AML
- environmental exposure of industrial chemicals such as benzene (ACS 2018).
In patients with pre-existing pre-leukaemic disorders (e.g. myelodysplasia, other myeloid neoplasms) and pre-disposing genetic disorders, routine care of these should include full blood counts and bone marrow biopsies at appropriate clinical intervals. This enables early detection in many circumstances. The frequency of blood tests and any bone marrow biopsies should be determined by standard frequency appropriate to the pre-existing or pre-disposing condition. For some conditions, such as myelodysplasia, validated risk assessment tools are available to guide practice in this regard.
There are no screening programs for AML.