Acute myeloid leukemia (AML) is a rare disease which mainly affects the elderly. It is a blood and bone marrow cancer which develops rapidly without therapeutic treatment.
In Europe, AML is the most common of the so-called myeloid malignancies, with an incidence rate of 3.7 per 100 000 per year. The 5-year relative survival rate for AML is 19%, almost half that for chronic myeloid leukemia (44%). The total number of new cases of myeloid malignancies in Europe is estimated at 43,000 per year.1
In the United States, the disease represents 1.2% of new cancer diagnoses each year, around one-third of all diagnosed leukemia cases, and nearly 10,000 deaths per year. Previously incurable, AML has a 5-year survival rate of 25% for patients over the age of 20 years and more than 65% for patients under the age of 20 years.2
This cancer is a proliferation of immature cells, which means the cells are not sufficiently developed and so cannot perform their normal functions. These cancerous cells are present in the blood, this is why the term “leukemia” is used, and mainly within the bone marrow hence the term “myeloid”. The bone marrow is the tissue present in the bones where the blood cells, known as “blasts”, are produced.
How does AML develop?
The disease occurs when there are changes in the DNA of a stem cell of the bone marrow during the development stage. The affected stem cell transforms into a leukemic cell and multiplies into millions of “leukemic blasts”, known as lymphoblasts.
Lymphoblasts block the production of normal blood cells, both red and white blood cells, as well as platelets, blood cells produced by the bone marrow that play an important role in coagulation.
The decrease in blood cells can be seen on lab tests. Therefore, in the majority of cases, anemia or a reduction in the number of red blood cells in the blood is observed, which often results in asthenia (significant fatigue), as well as thrombocytopenia (an abnormal decrease in the number of platelets in the blood). In some cases, neutropenia, i.e. a low level of white blood cells results in the weakening of the immune system despite it being programmed to protect the body from infections, can also be observed.
AML risk factors
For most patients with AML, there are no obvious causes. The main cause is rarely identified. Instead, there may be risk factors such as repeated exposure to benzene (cigarette smoke, petroleum products, work environment using benzene), certain genetic diseases such as Fanconi anemia or Down syndrome more commonly known as Trisomy 21, certain chemotherapy or radiotherapy, or the development of certain cancers and blood diseases. These different risk factors sometimes alter the DNA of blood cells located in the bone marrow.
Therapeutic management of AML
The main treatment for AML is based on chemotherapy in order to eliminate the cancerous cells.
In general, there are two treatment phases. An induction phase and a consolidation phase. The induction phase generally lasts one month and helps to kill the majority of cancerous cells. Consolidation therapy, meanwhile, helps to prevent relapse, i.e. the recurrence of cancerous cells. It is possible to combine chemotherapy with targeted therapies to prevent the growth of cancerous cells. In certain cases, a stem cell transplant may be considered. In both treatment phases of AML, supportive therapy is offered in order to combat the side effects of treatments and those caused by the disease.
And Servier ?
Servier has made oncology one of its foremost priorities, investing more than 50% of its R&D budget in the field. The Group hopes this will help it become a renowned innovator in developing cancer treatments.
The Group’s strategy in oncology is:
– To target hard-to-treat cancers where generally speaking needs are not yet met and hard to treat, such as acute myeloid leukemia;
– To concentrate on promising approaches: apoptosis, immunotherapy and metabolism;
– To draw on a wide range of expertise by relying on high-level teams that have been strengthened by the acquisitions, and by developing a network of diverse partners.
KEEP IN MIND
 Visser, A. Trama, M. Maynadié, C. Stiller, R. Marcos-Gragera, R. De Angelis, S. Mallone, C. Tereanu, C. Allemani, U. Ricardi, H.C. Schouten, Incidence, survival and prevalence of myeloid malignancies in Europe, Eur J Cancer, 2012; 48(17):3257-3266.