Treatments for acute myeloid leukemia
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.