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If you have acute myelogenous leukemia (AML), your healthcare team will create a treatment plan just for you. It will be based on your needs and may include a combination of different treatments. When deciding which treatments to offer for AML, your healthcare team will consider:
You may be offered the following treatments for AML. Treatment is usually given in 2 phases, called induction and consolidation. One type of AML is treated with a third phase, called the maintenance phase.
The main treatment for AML is chemotherapy. It is used in the induction phase and the consolidation phase. It is also given in the maintenance phase, if it is used.
For other types of leukemia, central nervous system (CNS) prophylaxis is an important part of treatment. CNS prophylaxis is treatment to make sure the leukemia does not spread to or stay in the fluid in and around the brain or spinal cord (called cerebrospinal fluid, or CSF). CNS prophylaxis is not given for AML because it spreads to the CNS in only 5% of people. If AML does spread to the CNS, it is treated with chemotherapy given directly into the CSF (called intrathecal chemotherapy) and with systemic chemotherapy. The chemotherapy given directly into the CSF is given during a lumbar puncturelumbar punctureA procedure in which a needle is inserted into the lower part (lumbar region) of the spinal column. or through an Ommaya reservoirOmmaya reservoirA device surgically implanted beneath the scalp that is used to deliver chemotherapy drugs directly into the cerebrospinal fluid (CSF) around the brain and spinal cord..
Doctors may consider giving a stem cell transplant to people with AML during a first complete remission or after an early first relapse and a second complete remission.
Stem cell transplant and the chemotherapy drugs used in preparation for a stem cell transplant can cause serious side effects, so not everyone can have this treatment. A reduced-intensity transplant may be an option for some people.
Before a stem cell transplant, blood cells are removed from the donor’s blood. If a relapse occurs after a stem cell transplant, the lymphocytes are given to the person through one or more infusions. This is called a donor lymphocyte infusion (DLI).
Radiation therapy may be used to treat AML. It may be given to:
Supportive therapy is given to treat the complications that usually happen with treatments for AML and the disease itself. Supportive therapy can include:
How well leukemia responds to treatment is an important factor. It helps doctors determine prognostic risk group and plan future care. The goal of treatment is to reach a complete remission.
Complete remission, or complete response, 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 immature blood cells (called blast cells, or blasts). 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.
Minimal residual disease (MRD) means that there are blast 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 blast cells can’t be seen with standard tests, such as looking at the cells under a microscope.
Active disease means that there are blast 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 blast cells.
Follow-up after treatment is an important part of cancer care. You will need to have regular follow-up visits after treatment has finished, as often as every few months for several years, even if there are no signs of the disease. The time between exams will become longer as time goes on, but you will need to have follow-up exams for a long period of time. These visits allow your healthcare team to monitor your progress and recovery from treatment.
Some clinical trials in Canada are open to people with AML. Clinical trials look at new and better ways to prevent, find and treat cancer. Find out more about clinical trials.
To make the decisions that are right for you, ask your healthcare team questions about treatment.
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