Leukemia Treatment Acute Myelogenous

Unlike chronic myelogenous leukemia, which can take months or years to become aggressive, acute myelogenous leukemia (AML) is an aggressive disease from onset. Like acute lymphocytic leukemia, chemotherapy is the primary treatment for acute myelogenous leukemia.

Induction Chemotherapy for Leukemia

Induction therapy for acute myelogenous leukemia should begin as soon as possible after diagnosis. Induction chemotherapy for leukemia kills the majority of cancer cells. Therapy for acute AML usually lasts a week, although some patients require longer induction periods.

Children undergoing acute myelogenous leukemia induction therapy usually receive two or three different chemotherapy medications. Healthy adults under the age of 60 may undergo similar therapy.

After age 60, the intensity of induction therapy for leukemia depends on the patient’s health. Older patients or adults in poor health may be treated with a single chemotherapy drug. In some cases, older patients may benefit more from supportive care to reduce symptoms rather than aggressive treatment.

Induction therapy aims for remission, or the absence of AML cells in the blood, and the reduction of immature bone marrow “blast” cells to less than 5 percent. Remission occurs in 40 to 80 percent of AML patients, with prognosis depending on:

  • Age
  • Health
  • Type of leukemia.

Remission of leukemia should not be confused with a cure: Without additional consolidation treatment, acute myelogenous leukemia cells will return to pre-treatment levels within a few months.

Induction Chemotherapy Side Effects

Chemotherapy side effects can be serious, and often need to be addressed during treatment for various types of leukemia. Antibiotics may be required to prevent or treat infection due to an impaired immune system. Chemotherapy kills healthy blood cells in addition to cancer cells, so transfusions of red blood cells and platelets may also be required to combat chemotherapy side effects.

Consolidation Chemotherapy for Leukemia (Post-Remission)

After acute myelogenous leukemia goes into remission, consolidation treatment begins. Also known as post-remission therapy, consolidation aims to kill any surviving leukemia cells.

Children or young adults may receive additional chemotherapy as part of consolidation therapy. Some patients benefit from stem cell transplants at this point.

Older patients or patients in poor health may undergo less intensive consolidation therapy. This may include lower-dose chemotherapy or a “mini stem cell transplant,” which uses less potent chemotherapy to prepare for the transplant.

Sub-Types of Leukemia and AML Treatment

Different sub-types of acute myelogenous leukemia require slightly different treatments. For instance, acute monocytic leukemia may invade the spinal cord and brain. If this occurs, induction chemotherapy for leukemia requires spinal taps to deliver medication directly into the spinal canal. Significant levels of leukemia cells in the central nervous system may require radiation therapy.

Acute promyelocytic leukemia has a better prognosis than most AML sub-types, and is sometimes treated with a combination of chemotherapy and all-trans retinoic acid (ATRA) during induction therapy. ATRA is derived from vitamin A. If induction therapy fails to bring about acute promyelocytic leukemia remission, the cancer may be treated with arsenic trioxide.

Resources

American Cancer Society. (2009). Typical treatment of acute myeloid leukemia (except promyelocytic m3). Retrieved April 2, 2010, from http://www.cancer.org/docroot/CRI/content/CRI_2_4_4x_Treatment_of_Acute_Myeloid_Leukemia_AML.asp.

Leukemia and Lymphoma Society. (2009). Acute myelogenous leukemia. Retrieved April 2, 2010, from http://www.lls.org/all_page?item_id=8459#treatment.

National Cancer Institute. (2009). Acute myeloid leukemia treatment (PDQ): Treatment option overview. Retrieved April 2, 2010, from http://www.cancer.gov/cancertopics/pdq/treatment/adultAML/Patient/page3.

Seiter, K. (2009). Acute myelogenous leukemia: Treatment and medication. Retrieved April 2, 2010, from http://emedicine.medscape.com/article/197802-treatment.