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The main treatment for acute myeloid leukaemia (AML) is chemotherapy| (chemo). This means having anti-cancer drugs to destroy the leukaemia cells. You’ll also have drugs called steroids, which help the chemo to work.
The treatment for AML is pretty intensive at times and can cause unpleasant side effects. But you'll be in hospital when you’re most likely to feel unwell and the staff will be able to help if things get tough.
There are different phases of treatment for AML:
Very often treatment is given as part of a clinical trial or research study. This helps doctors to keep improving treatment for leukaemia.
You usually start chemo pretty quickly after finding out that you have AML.
You’ll stay in hospital for your treatment. Teenagers are often treated in wards especially for young people with cancer.
Most chemo for AML is given into the bloodstream (intravenously). So you’ll have a ‘line’ put in to one of your main veins to make it easier for you to have intravenous chemo.There are different kinds of lines. You might have a central line (Hickman® or Groshong®) an implantable port (portacath), or a PICC line.
You’ll also be given chemo into the fluid around your spinal cord and brain. This is to get rid of any leukaemia cells that might be hiding there. This type of treatment is called central nervous system (CNS) therapy.
Having chemo can be hard, but the staff looking after you will give you medicines to help you cope with any side effects so you can stay strong enough to have treatment. And you’ll be given medicines to help you feel less sick and antibiotics to help prevent infections.
There will probably be times when you feel rough and other times when you’ll feel better. You might also feel upset, down or irritable. Talking to someone you trust can help you cope with these feelings.
Being in hospital for long periods can be frustrating, especially when you miss out on stuff happening at school or on things your friends are doing. You could try talking to your friends and family about this and see what they can do to help you.
The first phase of your treatment is about getting rid of the leukaemia. You’ll be given chemo to kill as many leukaemia cells as possible. Remission means there is no sign of leukaemia cells in your blood or bone marrow.
You have chemo over a few days then you have a few weeks off so that your body can recover from any side effects. The days you have the chemo and the rest period afterwards is called a cycle. Most people have several cycles of chemo.
You'll probably need to stay in hospital most of the time that you’re having remission induction. This is so that the doctors can check how things are going.
You’ll usually have two cycles of chemotherapy. For each cycle you’ll be given chemo drugs for about a week or so and then get a rest from the chemo for a week or two.
Drugs you may be given include:
We have more information about each of these individual drugs| in our general chemotherapy |section. This information is written for people of all ages, not just teens and young adults.
Chemo can cause side effects. For more information about these, have a look in the treatment section for each drug.
As well as the chemo drugs, you’ll be given other drugs to:
You’ll probably also need blood and platelet transfusions to top up the numbers of red cells and platelets in your blood.
Chemo can cause side effects. Most of them are short-term (temporary) and gradually disappear once treatment stops. The most common side effects are:
Sometimes side effects can be long-term. For example, some chemo treatments can affect fertility. There may be other late effects of treatment and your specialist can talk to you about this.
Remission induction is pretty intense treatment and you’ll probably feel a bit wiped out sometimes. You’ll need to stay in hospital for most of the time and you might not have the energy to do much. You might feel fed-up, tearful or irritable. It’s normal to feel like this. It's hard to be in hospital and you might worry about losing touch with your friends or falling behind at school or college. It can help to talk about this with a friend, nurse or counsellor.
This phase of treatment is also sometimes called consolidation or intensification treatment. It’s given to prevent the leukaemia from returning (known as a relapse).
When you’re in remission, it means the doctors can’t see any leukaemia cells in your blood or bone marrow samples when they check them under the microscope. But there may still be leukaemia cells hiding in your body, so further treatment is needed to get rid of these cells.
You start post-remission treatment soon after you complete remission induction. You’ll usually have two courses of treatment. You might be given the same chemo drugs you’ve had before (perhaps at similar or higher doses) or you might be given different chemo drugs.
When your doctors decide what chemotherapy treatment plan to give you they will take into account:
The following drugs may be used to treat you:
Sometimes cytarabine can cause sore eyes so you’ll be given eyedrops when you’re having it and for a few days afterwards. There is more information about the side effects of different chemo drugs in the chemotherapy section.
This treatment isn’t usually needed if you’re 16 or over. But if you’re under 16 you’ll probably be given it.
CNS therapy is given to get rid of any leukaemia cells that might be in the brain or spinal cord. (The CNS or central nervous system is the name for the brain and spinal cord).
CNS therapy involves giving chemotherapy into the fluid, called cerebrospinal fluid or CSF, around the spinal cord and brain.
It’s a bit like having a lumbar puncture| but with chemo added. A doctor puts a needle into the space between two small bones (vertebrae) near the bottom of your spine. Then they inject chemo into the CSF. The CSF will carry the chemo around your CNS so it can reach any leukaemia cells that might be there.
You’ll have a test called a lumbar puncture before you start treatment to check for leukaemia cells in the CSF.
If there is no sign of leukaemia cells you’ll be given two lots of CNS therapy, one after each cycle of remission induction therapy.
If there are leukaemia cells in the CSF you’ll have CNS therapy twice a week until there are all traces of leukaemia cells in your CSF have gone. You’ll then have two more lots of CNS therapy just to make sure.
For CNS therapy for AML you’ll be given chemo drugs called methotrexate and cytarabine and a steroid called hydrocortisone.
Some people also have radiotherapy (x-ray treatment) to their brain but this isn’t common. It’s most likely to be given if there were leukaemia cells in your spinal fluid when you were first diagnosed.
The most common side effect is feeling sick but you can be given anti-sickness treatment to help this. Rarer side effects include a headache, dizziness, tiredness, or blurry vision for a few hours afterwards.
We also have more info about:
| If you're looking for information about AML in people of all ages, please see our general AML| section.
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