Acute Myelogenous Leukemia (AML) - Adult

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Treatment

The objective of treatment is to eliminate the cancer cells with chemotherapy. Unfortunately, this process also eliminates normal cells that may be present in the bone marrow, so during treatment the patient is at risk from excessive bleeding caused by low numbers of platelets and infection caused by a low white blood count. It takes several weeks for the bone marrow to recover and start producing normal cells.

During this time supportive care is intensive. It consists of patient isolation to prevent infection, antibiotics to treat infection, transfusions of platelets to control bleeding and red blood cell transfusions to combat anemia.

After remission is achieved, further treatment is known as consolidation and is necessary in order to achieve a permanent cure. Consolidation may consist of either further chemotherapy, a bone marrow transplant or a stem cell transplant. These transplants may also be used in patients with relapsed disease.

Most of the different subtypes of AML have similar treatment. However, there are some differences in the treatment of one type of leukemia known as acute promyelocytic leukemia (APL). In this type of leukemia (and only this type), a medicine called all-trans retinoic acid (ATRA) is used to cause the leukemia cells to mature into normal white blood cellss.

ATRA is used during remission and consolidation treatments and has increased the cure rate for this type of AML. Additionally, the drug arsenic trioxide is approved for use in patients with APL who have failed treatment with ATRA or the usual chemotherapy. It can be used to achieve first remission or for later relapse.