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Decisions about your treatment

Find out about how your doctor decides which treatment you need, the types of treatment you might have and treatment by stage.

A team of doctors and other professionals discuss the best treatment and care for you. They are called a multi disciplinary team (MDT).

Your MDT might include:

  • blood cancer specialists called consultant haematologists
  • haematology nurse specialists, also called clinical nurse specialists (CNS)
  • dietitians
  • doctors specialising in reporting bone marrow or lymph node biopsies (haemopathologists)
  • doctors specialising in reporting x-rays and scans (radiologists)
  • doctors specialising in diagnosing and controlling infection (microbiologists)
  • social workers
  • symptom control specialists called palliative care doctors and nurses
  • pharmacists

Deciding which treatment you need

Your MDT will discuss your treatment, its benefits and the possible side effects with you. Your treatment will depend on:

  • the type of leukaemia you have
  • your age, general health and level of fitness
  • if you have gene changes (mutations) in the leukaemia cells

Main treatments

The main treatment for AML is chemotherapy.

Other treatments include:

  • radiotherapy
  • growth factors 
  • bone marrow and stem cell transplants

If you have a very high white blood cell count when you are diagnosed you might have leukapheresis. This removes the abnormal white blood cells from the blood. You won't have this if you have M3 AML, also called acute promyelocytic leukaemia. It can cause bleeding in this type of AML.

Other treatment

You might need other treatments to support you while you have your main leukaemia treatment. This might be because you have an infection or to help with the side effects of treatment. These include:
  • anti sickness medicines
  • painkillers
  • blood transfusions
  • platelet infusions
  • antibiotics

Treatment phases

Getting rid of the AML (induction)

The aim of the induction phase is to destroy the leukaemia cells. It's called remission induction. In remission there is no sign of the leukaemia in your blood or bone marrow.

The main treatment is chemotherapy.

The chemotherapy drugs kill off many of your bone marrow cells as well as the leukaemia cells. So you might need to stay in hospital for about a month until you have recovered.

Overall, between 5 and 7 out of 10 people (50 to 70%) with adult acute myeloid leukaemia go into remission with induction chemotherapy.

Stopping AML coming back (consolidation)

Once there is no sign of the leukaemia, you have consolidation treatment to stop it coming back again.

It may mean:

  • more chemotherapy
  • a bone marrow transplant
Your MDT will talk about a number of things when deciding which consolidation therapy to recommend to you. These include:
  • if your leukaemia is in full remission
  • if you have leukaemia after treatment for another cancer
  • whether you had chronic leukaemia that has changed into acute leukaemia
  • how many times you had chemotherapy before your leukaemia went into remission
  • your general level of fitness and health
  • your wishes about treatment

Intensive treatment

You might need more than one induction chemotherapy course before your leukaemia goes into remission. Then your doctor might suggest intensive chemotherapy treatment and:

  • a donor transplant - if a donor is available
  • a stem cell transplant using your own cells - this is rare

Having a bone marrow transplant is a very intensive treatment. Sometimes people die because of the treatment rather than from their cancer. People take this risk because transplant gives them the best chance of long term remission or cure.

You need to discuss all these pros and cons with your specialist team and the people close to you before making a decision.

Researchers are looking into the role of transplants in treating AML. The research aims to make these treatments safer and more successful.

AML that comes back or resists treatment

Sometimes tests find leukaemia cells in the bone marrow after you have had treatment. You might:
  • have more chemotherapy
  • have a stem cell transplant as part of a clinical trial
Sometimes the leukaemia comes back. This is called a relapse. Treatment for relapsed leukaemia depends on:
  • how long you were in remission
  • your age and general level of fitness
  • how your leukaemia cells look under the microscope

Your doctor will discuss all your treatment options with you.

Clinical trials to improve treatment

Your doctor might ask if you’d like to take part in a clinical trial.

Doctors and researchers do trials to:

  • improve treatment

  • make existing treatments better

  • develop new treatments

You can call the Cancer Research UK nurses on freefone 0808 800 4040. Lines are open 9am to 5pm, Monday to Friday. You can talk through your treatment options for AML.
Last reviewed: 
23 Jun 2016
  • Acute Myeloblastic Leukaemia in Adult Patients: ESMO Clinical Practice Guidelines
    M Fey and C Buske, 2013
    Annuals of oncology. Volume 24, Issue 6

  • Cancer and its management (7th edition)
    J Tobias and D Hochhauser 
    Blackwell, 2015

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