Adult Acute Myeloid Leukemia Treatment (PDQ�)
General Information About Adult Acute Myeloid Leukemia
Adult acute myeloid leukemia (AML) is a type of cancer in which the bone marrow makes abnormal myeloblasts (a type of white blood cell), red blood cells, or platelets.
Normally, the bone marrow makes blood
Red blood cellsthat carry oxygenand other materials to all tissuesof the body.
White blood cells that fight
infectionand disease. Plateletsthat help prevent bleeding by causing blood clotsto form.
In AML, the myeloid stem cells usually develop into a type of immature white blood cell called myeloblasts (or
This summary is about adult AML. See the following
Childhood Acute Myeloid Leukemia/Other Myeloid Malignancies Treatment Chronic Myelogenous Leukemia Treatment Adult Acute Lymphoblastic Leukemia Treatment Childhood Acute Lymphoblastic Leukemia Treatment Chronic Lymphocytic Leukemia Treatment
Hairy Cell Leukemia Treatment
There are different subtypes of AML.
Most AML subtypes are based on how mature (developed) the cancer cells are at the time of
Smoking, previous chemotherapy treatment, and exposure to radiation may affect the risk of developing adult AML.
Anything that increases your risk of getting a disease is called a
Smoking, especially after age 60.
Having had treatment with
chemotherapyor radiation therapyin the past.
Having had treatment for childhood
acute lymphoblastic leukemia(ALL) in the past.
Being exposed to atomic bomb
radiationor the chemical benzene.
Having a history of a blood
disordersuch as myelodysplastic syndrome.
Possible signs of adult AML include fever, feeling tired, and easy bruising or bleeding.
The early signs of AML may be like those caused by the flu or other common diseases. A doctor should be consulted if any of the following problems occur:
Shortness of breath.
Easy bruising or bleeding.
Petechiae(flat, pinpoint spots under the skin caused by bleeding).
Weakness or feeling tired.
Weight loss or loss of appetite.
Tests that examine the blood and bone marrow are used to detect (find) and diagnose adult AML.
The following tests and procedures may be used:
Physical examand history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient?s health habits and past illnesses and treatments will also be taken. Complete blood count(CBC): A procedure in which a sample of blood is drawn and checked for the following:
The number of red blood cells, white blood cells, and platelets.
The amount of
hemoglobin(the proteinthat carries oxygen) in the red blood cells.
The portion of the sample made up of red blood cells.
Peripheral blood smear: A procedure in which a sample of blood is checked for the presence of blast cells, number and kinds of white blood cells, the number of platelets, and changes in the shape of blood cells. Bone marrow aspirationand biopsy: The removal of bone marrow, blood, and a small piece of bone by inserting a hollow needle into the hipbone or breastbone. A pathologistviews the bone marrow, blood, and bone under a microscope to look for signs of cancer. Cytogeneticanalysis: A laboratory testin which the cells in a sample of blood or bone marrow are viewed under a microscope to look for certain changes in the chromosomes. Other tests, such as fluorescence in situ hybridization(FISH), may also be done to look for certain changes in the chromosomes. Immunophenotyping: A process used to identify cells, based on the types of antigensor markerson the surface of the cell. This process is used to diagnose the subtype of AML by comparing the cancer cells to normal cells of the immune system. For example, a cytochemistry study may test the cells in a sample of tissue using chemicals(dyes) to look for certain changes in the sample. A chemical may cause a color change in one type of leukemia cell but not in another type of leukemia cell. Reverse transcription? polymerase chain reactiontest (RT?PCR): A laboratory test in which cells in a sample of tissue are studied using chemicals to look for certain changes in the structure or function of genes. This test is used to diagnose certain types of AML including acute promyelocytic leukemia (APL).
Certain factors affect prognosis (chance of recovery) and treatment options.
The age of the patient.
The subtype of AML.
Whether the patient received chemotherapy in the past to treat a different cancer.
Whether there is a history of a blood disorder such as myelodysplastic syndrome.
Whether the cancer has spread to the central nervous system.
Whether the cancer has been treated before or recurred (come back).
It is important that acute leukemia be treated right away.
Stages of Adult Acute Myeloid Leukemia
Once adult acute myeloid leukemia (AML) has been diagnosed, tests are done to find out if the cancer has spread to other parts of the body.
The extent or spread of
Lumbar puncture: A procedure used to collect cerebrospinal fluidfrom the spinal column. This is done by placing a needle into the spinal column. This procedure is also called an LP or spinal tap. CT scan(CAT scan): A procedure that makes a series of detailed pictures of the abdomen, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dyemay be injectedinto a veinor swallowed to help the organsor tissuesshow up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
There are three ways that cancer spreads in the body.
Through the blood. Cancer cells travel through the blood, invade solid
tissuesin the body, such as the brain or heart, and form a solid tumor.
lymph system. Cancer cells invade the lymph system, travel through the lymph vessels, and form a solid tumor in other parts of the body.
Through solid tissue. Cancer cells that have formed a solid tumor spread to tissues in the surrounding area.
The new (
There is no standard staging system for adult AML.
The disease is described as untreated, in
Untreated adult AML
In untreated adult
complete blood countis abnormal.
At least 20% of the
cellsin the bone marroware blasts( leukemiacells).
There are signs or
Adult AML in remission
complete blood countis normal.
Less than 5% of the
cellsin the bone marroware blasts( leukemiacells).
There are no signs or
symptomsof leukemia in the brain and spinal cordor elsewhere in the body.
Recurrent Adult AML
Treatment Option Overview
There are different types of treatment for patients with adult acute myeloid leukemia.
Different types of treatment are available for patients with adult
The treatment of adult AML usually has 2 phases.
The 2 treatment phases of adult
Remission induction therapy: This is the first phase of treatment. Its purpose is to kill the leukemia cellsin the bloodand bone marrow. This puts the leukemia into remission. Post-remission therapy: This is the second phase of treatment. It begins after the leukemia is in remission. The purpose of post-remission therapy is to kill any remaining leukemia cells that may not be active but could begin to regrow and cause a relapse. This phase is also called remission continuation therapy.
Four types of standard treatment are used:
See Drugs Approved for Acute Myeloid Leukemia for more information.
Stem cell transplant
Other drug therapy
See Drugs Approved for Acute Myeloid Leukemia for more information.
New types of treatment are being tested in clinical trials.
This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI Web site.
Monoclonal antibody therapy is a cancer treatment that uses
Patients may want to think about taking part in a clinical trial.
For some patients, taking part in a
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from
Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from
Follow-up tests may be needed.
Some of the tests that were done to
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has
Treatment Options for Adult Acute Myeloid Leukemia
A link to a list of current
Untreated Adult Acute Myeloid Leukemia
Combination chemotherapy. High-dosecombination chemotherapy.
dose chemotherapy. Intrathecal chemotherapy. All-trans retinoic acid(ATRA) plus chemotherapy for the treatment of acute promyelocytic leukemia(APL).
clinical trialof arsenic trioxideand ATRA and combination chemotherapy for the treatment of APL.
A clinical trial of arsenic trioxide and ATRA and
targeted therapyfor the treatment of APL.
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with untreated adult acute myeloid leukemia. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Adult Acute Myeloid Leukemia in Remission
Combination chemotherapy. High-dose chemotherapy, with or without radiation therapy, and stem cell transplantusing the patient's stem cells.
High-dose chemotherapy and stem cell transplant using donor stem cells.
One of the treatments being studied in
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with adult acute myeloid leukemia in remission. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Recurrent Adult Acute Myeloid Leukemia
There is no
Combination chemotherapy. Targeted therapywith monoclonal antibodies. Stem cell transplant. Arsenic trioxide therapy.
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with recurrent adult acute myeloid leukemia. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
To Learn More About Adult Acute Myeloid Leukemia Cancer
For more information from the
Leukemia Home Page
What You Need to Know About? Leukemia
Drugs Approved for Acute Myeloid Leukemia
Understanding Cancer Series: Blood Stem Cell Transplants
Bone Marrow Transplantation and Peripheral Blood Stem Cell Transplantation
Targeted Cancer Therapies
Understanding Cancer Series: Targeted Therapies (Advances in Targeted Therapies)
What You Need to Know About? Cancer
Understanding Cancer Series: Cancer
Chemotherapy and You: Support for People With Cancer
Radiation Therapy and You: Support for People With Cancer
Coping with Cancer: Supportive and Palliative Care
Information For Survivors/Caregivers/Advocates
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Changes to This Summary (09/21/2011)
Images were added to this summary.
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