Having treatment for AML

The main treatment for acute myeloid leukaemia (AML) is chemotherapy (chemo). Sometimes you may have the option of having chemotherapy as part of a cancer research trial.

Chemotherapy drugs for AML are mainly given into a vein (intravenously). This might be by drip (intravenous infusion) or by injection. You may have a central line put in to make it easier for you to have treatment.

AML is treated in two main phases:

  • getting rid of the leukaemia
  • keeping the leukaemia away.

Chemotherapy treatment can cause different side effects. These depend on the drugs you have. Your doctor or nurse will tell you which ones you are more likely to get.

Having chemotherapy can be hard. But you will have medicines to help you cope with any side effects. It is important not to hide your feelings and ask for help if you need it.

The most common side effects are:

  • increased risk of infection
  • anaemia
  • bleeding and bruising.

The cause of these side effects is a low number of different types of blood cells. Chemotherapy for AML can cause hair loss, feeling sick and sore mouth.

If you are at high risk of leukaemia coming back after chemotherapy, doctors may offer you a stem cell transplant.

Having treatment for AML

The main treatment for acute myeloid leukaemia (AML) is chemotherapy (chemo). This means you have anti-cancer drugs to destroy the leukaemia cells.

The treatment can cause unpleasant side effects, so sometimes it may feel hard to deal with. But you will be in close contact with the hospital when you are most likely to feel unwell. The staff can help if things get tough. Don’t feel you have to be brave. Be honest about how you are feeling with your doctors and nurses and they can give you medicines to help.

AML is treated in two main phases:

  • getting rid of the leukaemia – this is called remission induction
  • keeping the leukaemia away – this is called consolidation and delayed intensification therapy.

You usually start chemotherapy quickly after finding out that you have AML.

Sometimes, you may have the option of treatment for AML as part of a cancer research trial. Cancer research trials try to find new and better treatments for cancer. The trials test new treatments, such as new chemotherapy drugs or targeted therapies. Or they may look at new ways of giving existing treatments.

Whether or not you take part in a cancer research trial is your decision. If you decide not to, you do not have to give a reason. But it can help to talk to the hospital staff about any questions or worries you have. This means they can give you the best advice. There will be no change in the way that the staff treat you. They will offer you the usual treatment for your situation.

If you are 18 or younger, you will have treatment in a specialist Principal Treatment Centre (PTC) for teenagers and young adults (TYA). If you are 19 or older, you can go to a PTC. Or you can choose to go to another hospital called a TYA designated hospital, if it is closer to home.

Chemotherapy

This video provides a brief overview of chemotherapy treatment, how it can be given, how it works and possible side effects.

About our cancer information videos

Chemotherapy

This video provides a brief overview of chemotherapy treatment, how it can be given, how it works and possible side effects.

About our cancer information videos


How chemotherapy is given

Chemotherapy drugs for AML are mainly given into a vein (intravenously). This might be by drip (intravenous infusion) or by injection. Chemotherapy given into a vein goes straight into the bloodstream. This means it can get to all areas of your body. Your treatment is usually given through a central line, PICC line or implantable port.

Central lines

You might have a central line put into one of your main veins to make it easier for you to have treatment. A central line can stay in until the chemotherapy is over. This means you will not have a needle put into your arm every time you have chemotherapy. Your nurses and doctors can also use the central line to take blood samples for blood tests.

There are different kinds of central lines. The most common type is called a skin tunnelled central line. You may hear them called Hickman or Groshong lines.

Other types of central line include:

Intrathecal chemotherapy

In some people, leukaemia cells may travel into the cerebrospinal fluid (CSF). This is the fluid that surrounds the spine and brain. It is harder for chemotherapy drugs in the bloodstream to reach the brain and spinal cord. To treat these areas, it is more helpful to inject the drugs directly into the CSF. This is done through a lumbar puncture. Having chemotherapy in this way is called intrathecal chemotherapy.

You have a local anaesthetic in your lower back. This numbs the area so you don’t feel any pain. The doctor gently puts a needle into the fluid in the spine. They take a sample of the fluid. This can be checked to see if there are any leukaemia cells in it. The doctor then injects the drugs into the space around the spine. The drugs help destroy any leukaemia cells in the fluid.

Some people get a headache after this treatment. Your doctor or nurse will give you painkillers for this. It can help if you lie flat for a short time afterwards.

PICC lines and central lines playlist

Watch our short animated videos about having PICC lines and central lines put in.

PICC lines and central lines playlist

Watch our short animated videos about having PICC lines and central lines put in.


Phases of treatment

Getting rid of the leukaemia (remission induction)

In the first phase of treatment you will have chemotherapy to kill as many leukaemia cells as possible. The aim is to get you into remission. Remission means there is no sign of leukaemia cells in your blood or bone marrow.

This type of treatment involves:

  • chemotherapy to kill the leukaemia cells
  • steroids to help the chemotherapy work
  • other drugs to help treat or prevent side effects from the chemotherapy.

You have chemotherapy 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 chemotherapy and the rest period together are called a cycle. You will usually have two cycles in the remission induction phase.

You will probably need to stay in hospital most of the time you are having this phase of treatment. This is so that the doctors can check how things are going and help with any side effects.

After remission induction treatment, doctors use blood and bone marrow tests to check for leukaemia cells. If the tests cannot find any leukaemia cells, the doctor will say you are in remission.

Keeping the leukaemia away (consolidation therapy and delayed intensification)

This phase of treatment is given to prevent the leukaemia from returning (relapsing).

Sometimes very small amounts of leukaemia cells may still be in your body. But they cannot be found by checking blood or bone marrow samples. So you need further treatment to make sure as many leukaemia cells as possible are destroyed.

You start this phase of treatment soon after you finish remission induction. You will usually have two courses of treatment. You might have the same chemotherapy drugs you have had before (at the same or higher doses). Or you might get different chemotherapy drugs.

When your doctors decide what chemotherapy treatment plan to give you they will think about:

  • the results of the tests you had when you were diagnosed
  • how well the first round of treatment (remission induction) worked on the leukaemia.


Chemotherapy drugs

You may have a few different chemotherapy drugs in each cycle. These may include:

We have more information about these drugs in our general chemotherapy section. This information is written for people of all ages, not just teenagers and young adults. Or you can call 0808 808 00 00 or visit be.macmillan.org.uk

As well as the chemotherapy drugs, you will have other drugs to:

  • help stop you feeling sick or being sick
  • help prevent infections
  • protect your kidneys – sometimes, destroying lots of leukaemia cells at once can cause kidney problems.

Side effects

Different chemotherapy drugs cause different side effects. Some people have a few side effects. Others may have more. Everyone is different.

Most side effects are short-term (temporary) and gradually stop after treatment finishes.

The most common short-term side effects are:

Chemotherapy can also lower the number of red cells and platelets in your blood. Low numbers of red cells (called anaemia) can make you feel breathless and tired. Low numbers of platelets may cause bleeding and bruising. You will probably need blood and platelet transfusions to help stop this from happening.

Other late effects

There may be other late effects of treatment. You can ask your specialist doctor or nurse about your risk of any long-term effects.


Stem cell transplant

Some people may have the option of having a stem cell transplant as part of their treatment. A stem cell transplant is when your bone marrow is replaced with bone marrow from a donor. This will give you a new, healthy bone marrow and your immune system can fight any remaining cancer cells.

You will usually only have this option if doctors think there is a high risk of the leukaemia coming back after chemotherapy.


Fertility

Treatment for AML can affect your ability to get pregnant or make someone pregnant (fertility). This is more likely if you have a stem cell transplant.

Before your treatment starts, your doctor and nurses will talk to you about how your fertility may be affected. They will explain what may be done to help preserve your fertility.

Young men may be able to store sperm before starting treatment. This is so it can be used later if they want to have children. Rarely, young women can store eggs or fertilised eggs (embryos) before chemotherapy. This is so they may be able to have children after treatment.

But treatment for leukaemia needs to start as soon as possible. Sometimes, there is not enough time to store sperm. Storing eggs or embryos is more complicated, so usually there is not enough time to store either of these.

We have more information about fertility in young men and women.


Coping with chemotherapy

Having chemotherapy can be hard. But the staff looking after you will give you medicines to help you cope with any side effects. Being able to cope with side effects will mean you can stay well enough to have treatment. You will have medicines to stop you feeling sick and antibiotics to help prevent infections.

Being in hospital for long periods of time is sometimes difficult. Even when you are home, there will probably be times when you feel rough and times when you feel better. If you are struggling to cope, try talking to friends, family, doctors and nurses. It is important not to hide your feelings.

Being in hospital or coming to hospital for treatment can be frustrating. It is especially frustrating when you miss out on school, college, university or work, or things your friends are doing. You could try talking to friends and family and see what they can do to help you. It can also help to talk to any new friends you’ve made, who are going through similar experiences to you.

We have more information about chemotherapy. This is written for people of all ages, not just teenagers and young adults. You can also find out more about individual chemotherapy drugs.

If you are looking for information about AML in people of all ages, please see our general AML section.

Back to AML

What is AML?

(AML) stands for a type of cancer called acute myeloid leukaemia.

Having tests for AML

Talk to your GP if you are worried about symptoms. They can arrange any tests you might need.