Treatment
Treatment of AML depends on subtype, lab test results, and other prognostic factors. Primary treatment for AML is chemotherapy, often combined with immunotherapy or stem-cell transplantation. It is important to start treatment immediately after diagnosis because AML progresses very rapidly. Treatment of AML is usually divided into three phases: induction, consolidation, and maintenance.
- Induction - Induction is the first phase of treatment for AML, in which your doctor will aim to put the cancer into remission. Your doctor will destroy the blasts in your blood and reduce the blasts in your bone marrow down to normal levels.
- Consolidation - Consolidation is the second phase of treatment for AML. After your cancer is in remission, your doctor will try to kill any small amount of cells left in your body after induction.
- Maintenance - Maintenance is the third phase of treatment for AML. The maintenance phase consists of lower doses of chemotherapy given for longer periods of time to ensure that the cancer does not return.
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Chemotherapy
Chemotherapy is the use of drugs to target rapidly growing cancer cells in an effort to destroy them. Doctors usually give a combination of different chemotherapy drugs to treat AML in the induction phase. In the consolidation phase, you may receive a different combination of chemotherapy drugs or high doses of chemotherapy combined with stem-cell transplantation. Chemotherapy medications may be given through the vein (intravenously) or by mouth (orally). Older patients or patients with comorbidities who cannot tolerate intensive chemotherapy are often offered low-intensity chemotherapy (such as hypomethylating agents) in combination with targeted therapy (e.g. venetoclax).
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High-dose chemotherapy with Stem-cell transplantation
This procedure allows patients to receive large doses of chemotherapy. These high doses destroy healthy cells in the blood and bone marrow, as well as cancer cells. After chemotherapy, the patient receives blood-forming stem cells that help the body form new, healthy blood cells.
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Targeted Therapies
These are small molecules given orally that can affect certain abnormalities detected during the molecular analysis. Given in addition to chemotherapy, these medicines can further improve the outcome.
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Radiation Therapy
Radiation therapy uses high-energy rays or particles to destroy cancer cells. Radiation therapy is not commonly used as a primary treatment for AML, but may be used to treat enlarged internal organs and areas of bone weakened or damaged by AML. Your doctor may also recommend undergoing low-dose radiation treatment to your entire body before a stem-cell transplantation.
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Leukapheresis
Your doctor may recommend this procedure to reduce the amount of leukemia cells in your blood before your chemotherapy treatment has a chance to start working. Your doctor will pass your blood through a machine that separates your white blood cells, including the leukemia cells, from your other blood cells. Your doctor will then return your healthy blood cells and plasma to your body. This is a short-term solution that temporarily reduces the amount of leukemia in your blood while the chemotherapy takes effect.
Clinical Trials
Clinical trials allow patients to try a new treatment before it is available to the general public. In some cases, this may be a new drug that has not been used in humans before, or it may be a drug or drug combination that is not currently used for that specific type of cancer. Early phase clinical trials are often used to test side effects of a drug or drug combination, while later phase clinical trials are used to see how effective a new treatment might be for a certain type of cancer. Clinical trials allow doctors and researchers to improve the treatment of cancers with possibly more effective therapies. A clinical trial may be a new, groundbreaking drug or it may have no effect. It is important to talk with your doctor about the pros and cons of clinical trials for your particular situation.
