Treatments for acute myeloid leukemia

Last medical review:

Your healthcare team will create a treatment plan just for you. The plan is based on your health and specific information about the cancer. What you want is also important when planning treatment. When deciding which treatments to offer for acute myeloid leukemia (AML), your healthcare team will consider:

  • the subtype of AML
  • any chromosome changes or genetic mutations
  • whether you have had chemotherapy in the past to treat a different cancer
  • whether you have had a blood disorder such as a myelodysplastic syndrome (MDS)
  • whether the cancer has spread to the brain and spinal cord (called the central nervous system, or CNS)
  • your age
  • your overall health
  • your white blood cell count

Chemotherapy is the main treatment for AML. Targeted therapy and a stem cell transplant may also be used.

Treatment for AML is often divided into phases:

Induction is the first phase of treatment. It involves intense chemotherapy. The goal of induction is to clear the blood and bone marrow of leukemia cells (blast cells, or blasts) and bring about a complete remission, or complete response. Targeted therapy may also be used if the cancer cells have certain genetic mutations.

Consolidation is the second phase of treatment. It may also be called post-remission therapy. The goal of consolidation is to continue to rid the body of leukemia cells that remain in the body after induction. It is done to maintain complete remission and prevent relapse. Consolidation usually involves chemotherapy or a stem cell transplant. Targeted therapy may also be used for certain genetic mutations.

Maintenance is a third phase of treatment that may be used for people who aren't going to have a transplant in the consolidation phase and who have intermediate or unfavourable chromosome changes. It involves chemotherapy at a lower strength and for a longer period of time. Maintenance therapy is generally lower strength and has fewer side effects than induction and consolidation therapy.

Response to treatment

Your healthcare team may measure the response to treatment at different periods throughout treatment. They will measure how you're responding to treatment by checking for leukemia cells in the bone marrow. The goal of treatment is to reach a complete remission.

Complete remission means that the numbers of blood cells (red blood cells, white blood cells and platelets) have returned to normal levels and less than 5% of cells in the bone marrow are leukemia cells . As well, there are no general signs or symptoms of AML and no signs or symptoms that AML has spread to the brain and spinal cord (called the central nervous system, or CNS) or anywhere else in the body.

Measurable residual disease (MRD) means that there are leukemia cells in the bone marrow, but they can only be seen using very sensitive tests, such as flow cytometry or polymerase chain reaction (PCR). The leukemia cells can’t be seen with standard tests, such as looking at the cells under a microscope.

Active disease means that there are leukemia cells still present during treatment or the disease comes back (relapses) after treatment. Active disease means that more than 5% of cells in the bone marrow are leukemia cells.

Find out more about terms used to describe response to treatment in staging for AML.

Expert review and references

  • Robert Turner, MD, FRCPC
  • John Storring, MD, CM
  • Alberta Health Services. Clinical Practice Guideline: Acute Myeloid Leukemia. Edmonton: 2019: https://www.albertahealthservices.ca/.
  • National Comprehensive Cancer Network. NCCN Guidelines for Patients: Acute Myeloid Leukemia. 2020.
  • Seiter K. Medscape Reference: Acute Myeloid Leukemia (AML) Guidelines . WebMD LLC; 2021: https://www.medscape.com/.
  • Sekeres MA, Guyatt G, Abel G, Alibhai S, Altman JK et al. American Society of Hematology 2020 guidelines for treating newly diagnosed acute myeloid leukemia in older adults. American Society of Hematology. Blood Advances. 2021: 4(15): 3528-3549.
  • PDQ® Adult Treatment Editorial Board. Acute Myeloid Leukemia Treatment (PDQ®) – Health Professional Version. Bethesda, MD: National Cancer Institute; 2021: https://www.cancer.gov/.
  • Leukemia and Lymphoma Society. The AML Guide: Information for Patients and Caregivers. Rye Brook, NY: 2019: https://www.lls.org/.

Induction treatments for acute myeloid leukemia

Induction treatment for acute myeloid leukemia (AML) is given over one week to clear the blood and bone marrow of leukemia cells. It is the first phase of treatment.

Consolidation treatments for acute myeloid leukemia

Consolidation treatment for acute myeloid leukemia (AML) is given soon after induction treatment to keep leukemia cells from coming back. It is the second phase of treatment.

Maintenance treatments for acute myeloid leukemia

Maintenance treatment for acute myeloid leukemia (AML) is oral chemotherapy given for a long time to prevent leukemia cells from coming back.

Treatments for relapsed or refractory acute myeloid leukemia

Relapsed, or recurrent, acute myeloid leukemia (AML), which has come back after treatment, and refractory AML, which did not respond to treatment, both need more treatment.

Treatments for acute promyelocytic leukemia

Acute promyelocytic leukemia (APL) is a subtype of acute myeloid leukemia (AML) that has its own treatment options.

Chemotherapy for acute myeloid leukemia

Chemotherapy uses drugs to destroy cancer cells and is the main treatment for acute myeloid leukemia (AML). Usually 2 or 3 drugs are given together.

Targeted therapy for acute myeloid leukemia

Targeted therapy uses drugs to target specific molecules on cancer cells. Acute myeloid leukemia (AML) is sometimes treated with targeted therapy.

Radiation therapy for acute myeloid leukemia

Radiation therapy uses high-energy rays to destroy cancer cells. It is sometimes used to treat acute myeloid leukemia (AML).

Stem cell transplant for acute myeloid leukemia

A stem cell transplant replaces blood-forming stem cells when stem cells or the bone marrow or both have been damaged.

Supportive therapy

Learn about supportive therapy, which is given to treat the complications of acute myeloid leukemia (AML) and its treatments.

Follow-up after treatment for acute myeloid leukemia

After cancer treatment, you'll likely have regular visits with your doctor to keep track of how you're doing and to make sure that any problems are found early.