Chemotherapy for Acute Myeloid Leukemia (AML)

Chemotherapy for Acute Myeloid Leukemia

The goal of chemotherapy is to use drugs to kill cancer cells. It is a type of systemic treatment, which means the drugs travel throughout your body in your bloodstream. Chemotherapy works by not allowing cells to grow and stopping them from reproducing. Its goal is to kill enough cancer cells to put the disease into remission and keep it there. Remission is when you no longer have signs or symptoms of cancer.

Chemotherapy is the first choice of treatment for acute myeloid leukemia (AML). If it doesn't work, your doctor may suggest another type of chemotherapy. This might be with a stem cell transplant. This depends on a variety of factors, such as your age, how quickly you relapse, and whether your leukemia is resistant to treatment.  

What happens during chemotherapy for AML

You may get chemotherapy during different phases of your treatment. The process may be relatively the same, but the types of drugs you get may change.

Chemotherapy for remission induction

The goal of remission induction is to kill leukemia cells so you no longer have symptoms. During this first phase of treatment, you will likely need to stay in the hospital. You may be in isolation to help protect you from other people's germs. You get chemotherapy through a vein. You usually take more than 1 drug at a time, which is called combination therapy. This reduces the chance that the cancer will develop a resistance to 1 drug. It also makes it more likely that the treatment will be successful. Which drugs you get, as well as how long you receive them, will depend on many factors, including your general health and age.

During this first phase of treatment, you are likely to receive cytosine arabinoside continuously for 7 days. This drug is also known as cytarabine or Ara-C. Your doctor will likely combine this with 3 days of an anthracycline drug that you'll also get intravenously. This 7-day plus 3-day protocol puts the leukemia cells in contact with drugs at various phases of their development. This makes it more likely that the cells will be killed. Your doctor may also add other drugs. You may also receive blood product transfusions during this time.

These are examples of drugs you may receive during the first phase of treatment:

  • Ara-C (cytarabine)

  • Anthracycline drugs such as Daunomycin (daunorubicin) or Idamycin (idarubicin)

Your doctor will check you closely for side effects. You are more likely to have side effects if you get high doses of the drugs during this and other phases of treatment.

When you need a second course of induction chemotherapy

About 2 weeks after you complete treatment, a doctor will do a bone marrow biopsy and aspiration. This is a way for your doctor to see whether leukemia is still present. If so, you may receive a second, similar course of chemotherapy. It will last fewer days than the first one.

Chemotherapy for postremission (consolidation) therapy

The goal of this phase of treatment is to keep you in remission or to prevent relapse. Even people who reach complete remission need a second phase of treatment. This is called consolidation and it helps prevent relapse. This phase of treatment destroys any leukemia cells that are left. You may have higher doses of chemotherapy drugs for several days. This will be repeated once a month for a few months. Another option may be very high-dose chemotherapy with a stem cell transplant. 

 
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