What to Expect
If you have been diagnosed with AML, you have most likely already had many tests, including urine and blood tests. A complete blood count (CBC) will be ordered, as well as a bone marrow biopsy to confirm AML.
When leukemia cells are found with the tests listed above, your doctor will order additional tests such as cytogenetics, fluorescent in-situ hybridization (FISH) and genetic tests to determine the type of leukemia. If your doctor learns you do have AML, further tests will be done to determine the specific type of AML. AML is not staged like most other cancers. The classification system used to classify the form of AML is the FAB Classification system devised by a team of physicians. FAB stands for French-American-British.
AML can get worse quickly, so doctors usually begin treatment right away. The goal of AML treatment is to achieve complete remission (CR). In complete remission, typically, the body has regained its ability to produce blood cells normally and the number of blood cells should return to normal ranges and no leukemic blast cells are detectable in the blood or the marrow.
There are two phases of treatment for AML, induction therapy and consolidation therapy (or postremission therapy).
Induction therapy is performed at the onset of an AML diagnosis. The goal of this treatment is to stop leukemic cells from multiplying and to drastically lower the percentage of existing ones through 'rapid cell kill'. To plan treatment, doctors look at a patient's risk factors (also called prognostic factors). Risk factors are patient and disease traits that clinical studies have linked to better or worse outcomes from treatment. Examples of risk factors can include a patient's age and subtype of AML. Children with AML will also receive induction therapy.
List of Treatments
- Medicines to kill the cancer cells, Combination Chemotherapy
- Antibiotics to treat infection
- Bone marrow transplant or stem cell transplant
- Red blood cell transfusions to fight anemia
- Transfusions of platelets to control bleeding
- Clinical Trials
Latest Treatment Options and Clinical Trials
There are constantly new treatments and developments for AML. Ask your doctor whether any newer treatment options may be available for you, including clinical trials. Whichever treatment you and your doctor choose, you may be asked to be part of a clinical trial. Even standard treatments continue to be studied in clinical trials. These studies help doctors learn more about which treatments work best for which patients. Sourced by marrow.org
Consolidation Therapy (Postremission Therapy)
In the consolidation phase the goal is to reactivate your immune system. The type of postremission therapy used largely depends on the type of AML. Further chemotherapy or bone marrow transplantation maybe be used if chemotherapy is found to be ineffective. For children, chemotherapy to the central nervous system is given. CNS includes the brain and spinal cord. This therapy is important because without it there is a one in five chance of a relapse.
Prognosis for AML varies dramatically and is dependent on multiple factors. The following are key factors in determining prognosis:
- Have you attained complete remission?
- You age.
- Your ability to survive the difficulties associated with induction therapy.
- Genetic findings during initial testing, including negative or positive for the FLT3 Gene Mutation.
- How long your symptoms were present prior to diagnosis.
- How quickly immature blast cells disappear after treatment is started.
Acute Promyelocytic Leukemia (APL)
Most types of AML are treated the same way. However, a form of AML called acute promyelocytic leukemia (APL) is treated with a medicine called all-trans retinoic acid (ATRA). This medicine helps leukemia cells grow into normal white blood cells. The drug arsenic trioxide is approved for use in patients with APL who do not get better with ATRA or chemotherapy. Sources by www.nlm.nih.gov