After a complete blood count, a bone marrow aspiration will be done to see if there are leukemia cells. If the doctor confirms leukemia, more tests will be done to identify the specific type of acute myeloid leukemia, which has eight sub-types.

Chemotherapy may be considered, although it also kills healthy cells, and may cause bleeding. Other options may be antibiotics for infections, transfusion of platelets to control bleeding, red blood cell transfusions for the anemia, bone marrow transplant or stem cell transplant, if available.

While undergoing treatment, the patient will be isolated as much as possible to avoid contracting infections.

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Visit the Leukemia and Lymphoma Society to search for support groups.

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The United States Food and Drug Administration (FDA) has approved Tasigna® (nilotinib) for the treatment of chronic and accelerated-phase chronic myeloid leukemia (CML) for patients who are not able to tolerate or who have stopped responding to Gleevec® (imatinib).

Tasigna® is an agent that also targets the same protein as Gleevec but through a different mechanism. Some trials have indicated that Tasigna is more potent than Gleevec; however, further study is necessary for this determination.

CML is a cancer that originates in the white blood cells, affecting approximately 4,600 people annually in the U.S. In the case of CML, large numbers of young WBCs do not mature, resulting in an excess accumulation of these cells.

Tasigna® is manufactured by Novartis Pharmaceuticals.

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A 14-year-old boy died Wednesday night in Seattle, hours after a Skagit County judge affirmed his right to reject treatment.

Dennis Lindberg, of Mount Vernon, died around 6 p.m. at Children’s Hospital & Regional Medical Center in Seattle. As a Jehovah’s Witness, Lindberg refused blood transfusions in his fight against leukemia, against doctors’ advice that he needed the transfusions to survive.

In court Wednesday, Superior Court Judge John Meyer said that Lindberg, though in the eighth grade, had the right to make that decision.

Doctors at Children’s diagnosed Lindberg’s leukemia early this month and began giving him chemotherapy. Because such treatment destroys the body’s ability to make red blood cells, transfusions were necessary, doctors said.

Lindberg’s relatives were in disagreement about whether the boy should have been forced to get the transfusions. His aunt, who was his legal guardian and is also a Jehovah’s Witness, supported his decision to refuse them. Lindberg’s parents, who live in Idaho, disagreed with their son and his guardian.

His doctors at Children’s supported the boy’s decision, Meyer said, although one doctor told the judge earlier that the boy’s blood count was so low he could die overnight. The case came to court after officials at Children’s reported it to the state, which went to court to force the transfusion.

Ethics experts and Jehovah’s Witness officials said such a court case is unusual these days.

“With an adolescent, the situation is much more complex,” says Dr. Doug Diekema, an ethics consultant at the hospital. “We all know that 14-year-olds change their minds; they become adults, and they have completely different belief systems. And that makes you nervous.”

Unlike the situation with very young children, “with adolescents, I think we find ourselves much more profoundly conflicted.”

Dr. Benjamin Wilfond, the hospital’s director of pediatric bioethics, said medical providers, along with parents, try to balance competing needs. “You’re trying to respect their wishes, their evolving autonomy, balanced against wanting to protect them. Often, it’s difficult to achieve both under all circumstances.”

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Adults may develop acute myeloid leukemia as they age. This form of leukemia is not common in children. “Myeloid” means the cells originate from the bone marrow or spinal cord. It is rare on people under the age of 40, adults are usually diagnosed at age 65.

Myeloid leukemia is caused mostly by carcinogens, or cancer-causing agents, such as benzene and tobacco smoke. Aging is the most important risk factor. It can also develop in people who have undergone chemotherapy earlier to treat other cancers – making the leukemia a secondary acute myeloid leukemia.

Symptoms include fatigue, fever, recurrent infections, night sweats, weight loss and bleeding. A complete blood count should be done, and check whether the white blood count is high, red blood cell count and platelet count are low – this may be leukemia.

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