The primary treatment for acute myeloid leukemia (AML) is chemotherapy. Targeted therapy, radiation, and stem cell transplant may also help. The main phases are induction and consolidation.
Acute myeloid leukemia (AML) is a type of cancer affecting the blood and bone marrow. Doctors typically recommend chemotherapy to treat the condition, though other treatments may also be necessary.
Read on to learn more about the possible treatments for AML, the phases of treatment, and more.
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In most cases, a person will receive the chemotherapy medication intravenously, or through a vein.
In rare cases that the cancer has spread to the brain or spinal cord, a person might receive chemotherapy in the cerebrospinal fluid. This is known as intrathecal chemotherapy.
The main chemotherapy medications for AML include a combination of cytarabine and an anthracycline drug, such as idarubicin or daunorubicin.
Other chemotherapy drugs for AML can include:
- 6-mercaptopurine (6-MP)
- azacitidine
- cladribine
- decitabine
- etoposide
- fludarabine
- hydroxyurea
- liposomal daunorubicin and cytarabine
- methotrexate
- mitoxantrone
Chemotherapy for AML is usually intensive. In some cases, such as if the individual is an older age, a doctor may recommend less intensive treatment.
Experiencing side effects with intensive chemotherapy is common. Some side effects can include:
- sickness
- diarrhea
- loss of appetite
- easy bruising
- easy bleeding
- tiredness
- hair loss
A doctor can provide information about the possible side effects of chemotherapy for AML and advise on ways to manage them.
Doctors may recommend other treatments for AML in addition to chemotherapy. Some other treatments can include:
- Bone marrow and stem cell transplants: A doctor may recommend bone marrow and stem cell transplants if there is a high risk of the cancer returning or if other treatments are not effective. Chemotherapy and radiation therapy may be necessary before the transplants.
- Radiation therapy: Radiation therapy helps kill cancer cells. It may be necessary before a transplant. It can also treat rare cases of AML where the cancer has spread to the brain or nervous system.
- Targeted therapy: Targeted therapy affects the way the cancer cells grow. Doctors
may recommend targeted therapy if FLT3, IDH1, or IDH2 gene mutations are present.
A person can speak with a doctor for more information about the treatment options they recommend for AML and what those treatments involve.
There are
- induction
- consolidation
- maintenance
Induction
The first phase, the induction phase, aims to destroy as many cancer cells as possible. It typically involves intensive chemotherapy, though the treatment may be less intensive for older individuals.
A typical course of induction chemotherapy involves receiving cytarabine for 7 days, as well as an anthracycline for the first 3 days of treatment.
Doctors may also administer targeted therapy during this phase if certain genetic mutations are present.
A person will typically need to stay in the hospital during the induction phase.
Consolidation
The second phase, the consolidation phase, aims to destroy any remaining cancer cells after the induction phase. This can help prevent relapse.
The main treatments during the consolidation phase are chemotherapy with high-dose cytarabine and stem cell transplant. Stem cell transplants are usually only suitable for younger, healthier individuals.
If a person received targeted therapy during the induction phase, they will likely continue to receive this during the consolidation phase.
Factors that can affect the type of consolidation treatment doctors recommend include:
- how many courses of chemotherapy a person received during the induction phase
- whether it is possible to collect bone marrow cells from the individual that are free from cancer
- whether there is a donor that matches the individual’s tissue type
- the individual’s age and overall health
A person can speak with their doctor to find out about the treatment options available to them.
Maintenance
The maintenance phase, or post-consolidation therapy phase, is the third phase of AML treatment. It involves receiving long term treatment to prevent the cancer from returning.
Not everybody with AML will receive maintenance therapy. Doctors may recommend this phase if there is a high risk of recurrence.
The treatment can involve oral chemotherapy or continuing targeted therapy.
Age and overall health can affect treatment decisions for people with AML as more intensive chemotherapy
However, if an older individual is in good health, doctors may recommend intensive chemotherapy or slightly less intensive treatment.
Non-myeloablative stem cell transplant may also be more suitable than other stem cell transplants. This treatment, also known as a mini-transplant, involves a lower dose of chemotherapy or radiation therapy before the transplant.
Researchers are investigating new approaches to killing AML cancer cells. Some clinical trials are focusing on:
- targeted therapies that target FLT3, IDH1, IDH2, and MLL genetic mutations
- new immunotherapy drugs that may kill cancer cells more effectively
- monoclonal antibodies, or specially made proteins, that attach to the cancer cells to help the body fight them
A person can speak with their doctor if they wish to learn more about the possibility of participating in clinical trials.
Chemotherapy is the main treatment for acute myeloid leukemia (AML). An individual will usually receive intensive chemotherapy during the induction phase of treatment.
Doctors may also administer targeted therapy during the first phase if certain genetic mutations are present.
The aim of the second, or consolidation, phase is to kill the remaining cancer cells and reduce the chance of recurrence. Treatments during this phase can include chemotherapy, targeted therapy, radiation therapy, and stem cell transplants.
Some people will receive maintenance therapy. This involves long term treatment to reduce the likelihood of the cancer coming back.
A person can speak with a doctor about the treatment options for AML. Treatments can depend on factors such as the age and overall health of the individual. The doctor can also provide information about what the treatments involve and possible side effects.