Maintenance treatments for acute myeloid leukemia
Maintenance is a third phase of treatment that may be used for people with AML that has intermediate or unfavourable chromosome changes. Maintenance follows consolidation. The goal of maintenance treatment for AML is to prevent leukemia cells from coming back (called relapse) and clear any leukemia cells that might remain (called measurable residual disease). Maintenance therapy may be given for a long time until the disease progresses or it becomes too hard to cope with the side effects.
Chemotherapy uses anticancer drugs to destroy cancer cells. Chemotherapy is the main maintenance treatment for AML. Maintenance chemotherapy may be given to people with AML with intermediate or unfavourable chromosome changes who are unable to have a stem cell transplant. Maintenance chemotherapy is most commonly given as oral azacitidine (Onureg).
Find out more about chemotherapy for AML.
Targeted therapy @(Model.HeadingTag)>
Targeted therapy uses drugs to target specific molecules (such as proteins) on cancer cells or inside them to stop the growth and spread of cancer.
Sorafenib (Nexavar) is an FLT3 inhibitor that may be used as maintenance therapy for people who have received a stem cell transplant and are in remission from AML with the FLT3 mutation.
Find out more about targeted therapy for AML.
Supportive therapy @(Model.HeadingTag)>
Supportive therapy is important during every phase of AML treatment. It is used to treat the complications that usually happen with treatments for AML and the disease itself.
Supportive therapies given during maintenance treatment may include:
- antibiotics and antifungals to treat infections
growth factorsto help the bone marrow recover from chemotherapy (chemotherapy can affect the bone marrow so it doesn’t make enough healthy blood cells, which can increase the risk for infection)
- transfusions of red blood cells, platelets, fresh frozen plasma and cryoprecipitate (a product that replaces clotting factors) as needed
Find out more about supportive therapy.
Clinical trials @(Model.HeadingTag)>
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.
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/.
Provincial Health Services Authority. BC Cancer Protocol Summary: Treatment of Acute Myeloid Leukemia using Gemtuzumab Ozogamicin with Induction and Consolidation Chemotherapy. Vancouver, BC: 2021: http://www.bccancer.bc.ca/.
Provincial Health Services Authority. BC Cancer Protocol Summary: Therapy of Myelodysplastic Syndrome and Acute Myeloid Leukemia using azaCITIDine. Vancouver, BC: 2021: http://www.bccancer.bc.ca/.
Cancer Care Ontario. Your Treatment Pathways for Acute Myeloid Leukemia (AML). https://www.cancercareontario.ca/en. Tuesday, November 16, 2021.
American Society of Clinical Oncology (ASCO) . Cancer.net: Leukemia – Acute Myeloid . 2017 : https://www.cancer.net/.
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Acute Myeloid Leukemia (Version 3.2021). 2021: https://www.nccn.org/home.
Seiter K. Medscape Reference: Acute Myeloid Leukemia (AML) . WebMD LLC; 2021: https://www.medscape.com/.
Seiter K. Medscape Reference: Acute Myeloid Leukemia (AML) Guidelines . WebMD LLC; 2021: https://www.medscape.com/.