Treatment for acute myeloid leukaemia (AML)
There are different treatments for acute myeloid leukaemia. Treatment usually starts as soon as possible after diagnosis.
The aim of treatment for acute myeloid leukaemia (also called AML or AML leukemia) is to get rid of the leukaemia cells as quickly as possible, so your bone marrow can work normally again. This is called remission.
Treatments for AML include:
Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy the leukaemia cells. This is the main treatment for AML. You will have several different chemotherapy drugs. Most of these will be given into a vein (intravenously). Some people may also have chemotherapy as a small injection under the skin. Rarely, chemotherapy is given into the fluid around the spine. This is called intrathecal chemotherapy.
Targeted therapy drugs target something that is helping leukaemia cells grow and survive. This treatment is sometimes given with chemotherapy for AML. Some targeted therapy drugs are only effective in treating certain types of AML. Your doctor or nurse will explain if they are suitable for you. They will give you information about the drug, how it is taken and possible side effects.
ATRA or arsenic trioxide
Stem cell transplant
A stem cell transplant is an intensive treatment that may increase the chances of curing AML or keep it in remission for longer. This treatment is not suitable or needed for everyone. Some people will have a donor or allogeneic stem cell transplant. Rarely, people with AML will have a stem cell transplant using their own stem cells. This is called an autologous stem cell transplant.
Treatment for acute leukaemia usually starts as soon as possible after diagnosis. Most people in the UK have treatment for AML as part of research called clinical trials. Before you have any treatment, your doctor will explain your treatment plan and possible side effects. They will also talk to you about things to think about when making treatment decisions.
Your treatment plan may depend on the type of AML you have and your general health.
We understand that having treatment can be a difficult time for people. We're here to support you. If you want to talk, you can:
The aim of intensive treatment is to cure AML or get a long-term remission. Intensive treatment is usually given in 2 main phases.
- Induction phase – chemotherapy and sometimes other drugs are given to get rid of the leukaemia cells in your blood and bone marrow.
- Consolidation phase – further chemotherapy is given to get rid of any remaining leukaemia cells to prevent the leukaemia coming back. Some people may also have a stem cell transplant.
For intensive treatment you stay in hospital for a few weeks at a time. You may stay in for longer if you need treatment to manage side effects, or if you have a stem cell transplant. Your doctor and nurse will explain your exact treatment plan and what to expect in each phase.
Non-intensive treatment uses lower doses of chemotherapy or other drugs to control AML for as long as possible. You may be able to have some treatments as an outpatient and go home the same day.
You may have non-intensive treatment if you have other medical conditions or health problems. Non-intensive treatment has less risk of serious side effects and may be easier to cope with.
You will usually have your treatment in a hospital that offers specialist treatments, such as chemotherapy and stem cell transplants. These are usually larger hospitals, so you may have to travel for your treatment and appointments.
Teenagers and young adults
Some hospitals have cancer units for teenagers and young adults. These are sometimes called TYA units. Other hospitals may have a ward or area for teenagers. Not every hospital offers this. You may have to travel further from home to have treatment at one.
Having your treatment in a TYA unit means you can be with other young people. There may be a kitchen you can use or spaces to relax and meet friends. The staff are trained in looking after young people with cancer and understand what you are going through.
You might not be able to go to a hospital that has a TYA unit or you may choose not to. This may mean you are treated on a cancer ward for adults. Overall, your treatment and care will be the same.
Many treatments for acute leukaemia are given into your bloodstream. These are given through a line put into a vein.
During induction treatment, you may have a short thin tube called a cannula. This is put into a vein in the back of your hand or lower arm. Your nurse will place a clear dressing over it to make sure it stays in place. Having a cannula put in can be a bit uncomfortable or painful, but it should not take long and any pain soon gets better. A cannula can stay in place for several days if needed.
Central lines PICC lines and ports
By the start of your consolidation treatment, you will have a central line, PICC line or port put in. This type of line can stay in place for several months and you can go home with it. It is used to give treatments into your bloodstream. It can also be used to take blood samples.
Most people get used to having a line or port. Your nurse will explain how to look after your line or port so that it does not get blocked or cause infection. They will arrange any support you need. If you are worried about your line or port, contact your team in the chemotherapy clinic or on the ward.
Leukaemia and treatment for leukaemia can cause symptoms and side effects. Your doctor will monitor these and give you supportive treatment to prevent or manage them. This may include having:
- red blood cells or platelets given into a vein if you have low numbers of these cells – called a blood or platelet transfusion
- drugs to prevent infections if you have low numbers of healthy white blood cells
- drugs to prevent or manage side effects of treatment.
We also have more information about looking after yourself during treatment and while you recover.
Below is a sample of the sources used in our acute myeloblastic leukaemia (AML) information. If you would like more information about the sources we use, please contact us at email@example.com
British Committee for Standards in Haematology. Milligan DW et al. Guidelines on the management of acute myeloid leukaemia in adults. British Journal of Haematology. 2006. 135: 450–474.
Fey MF and Buske C. Acute myeloblastic leukaemia in adult patients: ESMO clinical practice guidelines. Annals of Oncology. 2013. 24 (Supplement 6): vi138-vi143.
National Institute for Health and Care Excellence. Blood and bone marrow cancer. www.nice.org.uk/guidance/topic/conditions-and-diseases/blood-and-immune-system-conditions/blood-and-bone-marrow-cancers (accessed July 2018).
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Anne Parker, Consultant Haematologist.
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