Treating Acute Myelogenous Leukemia
Talk with your doctor about the best plan for you. Treatment of AML usually involves two phases:
- Remission induction therapy-to kill leukemia cells
- Maintenance therapy-to kill any remaining leukemia cells that could grow and cause a relapse
Treatment options include:
Chemotherapy is the use of drugs to kill cancer cells. It may be given in many forms. This includes pill, injection, and via a catheter. The drugs enter the bloodstream and travel through the body. While this will focus on cancer cells, some healthy cells are also killed.
Some AML may spread to the brain and spinal cord. In this case, intrathecal chemotherapy may be used. Chemotherapy drugs are placed directly into the spinal column.
Radiation therapy involves the use of radiation to kill cancer cells and shrink tumors. For AML, external radiation therapy is used.
The radiation is directed at the tumor from outside the body. This type of treatment is used for AML that has spread, or may spread, to the brain and spinal cord. It can also be used to treat bone pain that comes from bone affected by the leukemia.
Chemotherapy is followed by a transplantation of stem cells (immature blood cells). These will replace blood-forming cells destroyed by cancer treatment. Stem cells are removed from the blood or bone marrow of the patient or donor. They are then infused into the patient.
These drugs may be used with certain types of leukemia. They can kill leukemia cells, stop them from dividing, or help them mature into white blood cells:
- Arsenic trioxide
- All-trans retinoic acid (ATRA)
A targeted therapy has been approved by FDA. It is approved for patients older then 60 years who relapsed after initial therapy. The CD33 receptor on leukemia cells is targeted with:
- Gemtuzumab ozogamicin (Mylotarg)
This is the use of medications or substances made by the body. The substance is used to increase or restore the body's natural defenses against cancer. This type of therapy is also called biological response modifier therapy. It is still being tested in clinical trials.
Patients will suffer side effects not only from the leukemia, but from therapy. These include:
- A reduction in red blood cells (anemia)
- Reduced numbers of platelets that assist in blood clotting (thrombocytopenia)
- Decreased numbers of the white blood cells that fight infection
Anemia may lead to fatigue. If severe enough, it can complicate respiratory or cardiac disease. Thrombocytopenia may lead to bleeding and bruising. Decreased numbers of white blood cells leave a patient more vulnerable to infection.
Your doctor may prescribe a number of different treatments to decrease these side effects. Drugs are available to increase production of normal blood cells. In addition, when your counts are particularly low, blood transfusions or changes in daily activities may be needed. These step will reduce the chance of fatigue, bleeding, or infection.