Days after Tatiana Schlossberg announced that she has terminal cancer, the spotlight is on the warning signs of acute myeloid leukemia (AML).
John F. Kennedy’s granddaughter, 35, shared the details of her diagnosis in an essay published in The New Yorker on Nov. 22.
Schlossberg, who is the daughter of Kennedy’s daughter, Caroline Kennedy, and Edwin Schlossberg, learned of her disease in May 2024.
She wrote that one doctor predicted she would live for about a year.
The first indicator of Schlossberg’s disease was an abnormally high white blood cell count, which doctors detected just hours after she gave birth to her second child.
What is acute myeloid leukemia?
AML is a type of leukemia that begins in the bone marrow, the soft, inner tissue of certain bones where new blood cells are produced, according to the American Cancer Society.
This type of cancer typically spreads rapidly from the bone marrow into the bloodstream and can also reach other parts of the body, such as the lymph nodes, liver, spleen, brain and spinal cord, and testicles, per ACS.
In some cases, clusters of leukemia cells may form a solid mass known as a myeloid sarcoma.
Schlossberg’s AML stems from a rare gene mutation known as inversion 3, which is an abnormality of chromosome 3 in the leukemia cells.
“Inversion 3 correlates with a very high rate of resistance to standard chemotherapy treatments and, therefore, very poor clinical outcomes,” Dr. Stephen Chung, a leukemia expert and oncologist at UT Southwestern Medical Center in Dallas, Texas, told Fox News Digital. (Chung was not involved in Schlossberg’s care.)
Red flags and risk factors
The most common symptoms of Schlossberg’s type of cancer include sudden onset of severe fatigue, shortness of breath with exertion, unusual bleeding or bruising, fever and infections, according to Dr. Pamela Becker, professor in the Division of Leukemia at City of Hope, a U.S. cancer research and treatment organization in California, who also did not treat Schlossberg.
Chung noted that AML usually causes abnormally low blood cell counts, or in some cases an abnormally high white blood cell count.
“This may be picked up in routine testing for other purposes, or because the patient develops symptoms from these low blood counts,” he said.
AML can sometimes resemble a severe flu with a generally unwell feeling, noted Robert Sikorski, M.D., Ph.D., a hematology/oncology expert and chief medical officer of Cero Therapeutics in California.
“Some patients also experience bone pain or night sweats,” he told Fox News Digital.
Known risk factors for AML include prior chemotherapy or radiation, smoking, long-term benzene exposure and certain inherited syndromes, although most cases occur without any identifiable cause, according to Sikorski, who has not treated Schlossberg.
In some rare cases, people can inherit mutations that cause AML to run in families, with recent research suggesting that these cases may be more common than previously thought, Chung noted.
“We used to only check for this in younger AML patients, but we now believe all patients should be screened for these mutations,” he said.
Treatment for AML
The standard treatment for AML is intensive chemotherapy with a combination of two drugs, with additional agents added based on each patient’s specific characteristics, according to Becker.
For patients with higher-risk types of AML, the chemotherapy is usually followed by a stem cell (bone marrow) transplant to prevent relapse. The transplants come from matched donors, often family members.
“This is a much more involved process that usually involves another month in the hospital, followed by close follow-up for many months, as well as a much higher risk for treatment-related side effects,” Chung said.
There is not a specific treatment that is effective for Schlossberg’s specific chromosome abnormality, the doctors noted, although some new cellular therapies and immunotherapies are being investigated.
For older patients who are not strong enough to receive intensive chemotherapy, the standard treatment is venetoclax/azacytidine (a combination therapy used to treat certain types of AML), Chung said.
“This can often be given mostly outside the hospital on a monthly basis,” he said. “While it technically is not considered to be curative, it can work very well — in some cases, patients remain in remission for many months, if not years.”
Hope ahead
There is hope on the horizon, as AML treatment has advanced more in the past decade than in the previous 30 years, according to Sikorski.
“New targeted drugs have been approved in several AML subtypes, and early work in immune-based therapies, including CAR-T and other engineered cell therapies, is beginning to reach clinical trials for AML,” Sikorski, told Fox News Digital.
“Supportive care has also improved significantly, which helps patients tolerate treatment more effectively.”
While there is not yet a drug tailored specifically to inversion 3, he reiterated, “many studies focused on high-risk AML are actively enrolling these patients, and the overall treatment landscape continues to expand.”
