Chemotherapy for acute myeloid leukaemia (AML)

Chemotherapy is the main treatment for acute myeloid leukaemia (AML). 

You will probably have to stay in hospital whilst having chemotherapy for AML. This is because:

  • it's demanding treatment
  • you have side effects that the hospital staff will help you with
  • you might need antibiotics into a vein to treat infection

What is chemotherapy?

Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. The drugs circulate throughout the body in the bloodstream.

Phases of treatment for AML

Your treatment is in two phases:

  • getting rid of the AML (induction)
  • treatment to stop AML coming back (consolidation)

Some people may also have chemotherapy to keep their AML away. This is called maintenance therapy.

Getting rid of the AML (remission induction)

The aim of induction is to destroy the leukaemia cells.

When you have treatment

You have 2 or more different chemotherapy drugs in cycles of treatment. You have treatment for a few days, then a rest period. After the rest period, you might have more treatment.

Types of chemotherapy

You usually have a combination of 2 or more chemotherapy drugs to get rid of the leukaemia cells.

The 2 main drugs are:

  • cytarabine
  • daunorubicin

You might also have a targeted cancer drug with your chemotherapy.

You might also have:

  • idarubicin
  • mitoxantrone
  • etoposide
  • thioguanine
  • fludarabine

Treatment to stop AML coming back (consolidation)

When there are no signs of the leukaemia it is in remission. You have treatment to stop it coming back (consolidation).

When you have treatment

There are different types of consolidation treatment. Your team will tell you which combination of drugs you will have and when you will have them.

Types of chemotherapy

You normally have a combination of drugs. These include:

  • amsacrine
  • high dose cytarabine
  • etoposide
  • daunorubicin
  • fludarabine
  • idarubicin

Some people have high dose chemotherapy and then a bone marrow or stem cell transplant.

Keeping AML away long term (maintenance)

The aim of maintenance treatment is to help keep the leukaemia in remission. You have more chemotherapy, but in lower doses than in the other phases of treatment. Chemotherapy drugs include:

  • azacytidine
  • decitabine

The maintenance phase lasts for about 2 years. You usually have this as an outpatient, and most people can go back to work, school or college during this phase.

Before you start chemotherapy

You need to have blood tests to make sure it’s safe to start your treatment. You have these either a few days before or on the day your treatment begins. You have blood tests before each round or cycle of treatment.

How you have chemotherapy for AML

You usually have chemotherapy directly into your bloodstream for AML.

You need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or in your arm. It stays in while you are having treatment.

You might have cytarabine as a small injection just under the skin (subcutaneously).

Side effects

Treatment for AML can cause side effects.

Clinical trials

Dietary or herbal supplements

We don't yet know much scientifically about how some nutritional or herbal supplements might interact with chemotherapy. Some could be harmful.

It is very important to tell your doctors if you take any supplements, or if you are prescribed them by alternative or complementary therapy practitioners. 

Talk to your specialist about any other tablets or medicines you take while you are having active treatment.

Some studies seem to suggest that fish oil preparations might make some chemotherapy drugs work less well. If you take or are thinking of taking these supplements, talk to your doctor to find out whether they could affect your treatment.

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