Follow-up after treatment for acute myeloid leukaemia (AML)

Many people find they get very anxious before their appointments. This is natural and it may help to get support from family, friends or a support organisation|.

If you have any problems, or notice any new symptoms| between these times, let your hospital doctor know as soon as possible.

After treatment, you may still have some physical effects to cope with. How quickly things improve will depend on the treatment you’ve had, your age and general health. Some side effects that develop during treatment may take a long time to get better. It’s important to remember that it can take some time for you to fully recover, so try not to expect too much of yourself too soon.

For people whose treatment is over apart from regular check-ups, we have a section on adjusting to life after cancer treatment|, which gives useful information on how to keep healthy and adjust to life after cancer.

Monitoring minimal residual disease

Sometimes, even though the leukaemia appears to have gone, a small number of leukaemia cells may be left behind after treatment. This is called minimal residual disease (MRD).

It may not be possible to detect any leukaemia cells in your blood or bone marrow samples. However, doctors can now test for genetic changes in the cells that show how successful the treatment has been, and whether it’s possible that the leukaemia may come back (relapse). If there’s a risk of a relapse, your doctors may suggest further treatment, such as high-dose treatment|.

Your doctors will look for MRD using a test called polymerase chain reaction (PCR) and immunophenotyping|. PCR is a very sensitive test that looks for genetic changes in the cells. It can find a single leukaemia cell among a million normal cells. Immunophenotyping looks for certain proteins that are made by leukaemia cells.

If AML comes back (relapse)

Chemotherapy can cure AML. Sometimes, however, it may relapse, which can be very disappointing and upsetting. If this happens, your specialist will advise you on how best to treat| it, and work out the most positive approach for you. Your AML may be resistant to the drugs you had initially, so different drugs or new combinations of different drugs may be needed to give you further remissions.