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Treatments and drugs
By Mayo Clinic staffTreatment of acute myelogenous leukemia depends on several factors, including the subtype of the disease, your age, your overall health and your preferences. In general, treatment falls into two phases:
- Remission induction therapy. The purpose of the first phase of treatment is to kill the leukemia cells in your blood and bone marrow. However, remission induction usually doesn't wipe out all of the leukemia cells, so you need further treatment to prevent the disease from returning.
- Consolidation therapy. Also called post-remission therapy, maintenance therapy or intensification, this phase of treatment is aimed at destroying the remaining leukemia cells. It's considered crucial to decreasing the risk of relapse.
Therapies used in these phases include:
- Chemotherapy. Chemotherapy is the major form of remission induction therapy, though it can also be used for consolidation therapy. Chemotherapy uses chemicals to kill cancer cells in your body. People with AML generally stay in the hospital during chemotherapy treatments because the drugs destroy many normal blood cells in the process of killing leukemia cells. If the first cycle of chemotherapy doesn't cause remission, you may need it repeated one or two more times.
- Other drug therapy. Arsenic trioxide (Trisenox) and all-trans retinoic acid (ATRA) are anti-cancer drugs that can be used alone or in combination with chemotherapy for remission induction of a certain subtype of AML called promyelocytic leukemia. These drugs cause leukemia cells with a specific gene mutation to mature and die, or to stop dividing.
- Biological therapy. Also known as immunotherapy, biological therapy uses substances that bolster your immune system's response to cancer. Monoclonal antibodies are one form of biological therapy. These antibodies are produced in a laboratory, but they mimic proteins in your immune system (antibodies) that attack foreign substances on leukemic cells. One monoclonal antibody used as a biological therapy in AML is gemtuzumab ozogamicin (Mylotarg). This drug carries a chemical toxin that releases when it attaches to AML cells.
- Bone marrow stem cell transplant. Bone marrow stem cell transplant may be used for consolidation therapy. Bone marrow stem cell transplant helps re-establish healthy stem cells by replacing unhealthy bone marrow with leukemia-free stem cells that will regenerate healthy bone marrow. Prior to a stem cell transplant, you receive very high doses of chemotherapy or radiation therapy to destroy your leukemia-producing bone marrow. Then you receive infusions of stem cells from a compatible donor (allogeneic transplant). You can also receive your own stem cells (autologous transplant) if you were previously in remission and had your healthy stem cells removed and stored for a future transplant.
- Clinical trials. Some people with leukemia choose to enroll in clinical trials to try experimental treatments or new combinations of known therapies.
