Treatment for acute myeloid leukaemia (AML)
There are different treatments for acute myeloid leukaemia. Treatment usually starts as soon as possible after diagnosis.
About acute myeloid leukaemia (AML) treatment
The aim of treatment for acute myeloid leukaemia (also called AML or AML leukemia) is to get rid of the leukaemia cells as quickly as possible, so your bone marrow can work normally again. This is called remission.
Treatment for AML usually starts as soon as possible after diagnosis. Your treatment plan will depend on:
- the subtype of AML
- whether there are gene changes in the leukaemia cells
- your general health.
Treatments for AML include:
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Chemotherapy
Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy the leukaemia cells. This is the main treatment for AML. You will have several different chemotherapy drugs. Most of these will be given into a vein (intravenously). Some people may also have chemotherapy as a small injection under the skin. Rarely, chemotherapy is given into the fluid around the spine. This is called intrathecal chemotherapy.
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Targeted therapy
Targeted therapy drugs target something that is helping leukaemia cells grow and survive. This treatment is sometimes given with chemotherapy for AML. Some targeted therapy drugs are only effective in treating certain types of AML. Your doctor or nurse will explain if they are suitable for you. They will give you information about the drug, how it is taken and possible side effects.
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ATRA or arsenic trioxide
If you have a type of AML called acute promyelocytic leukaemia (APL), your treatment may include drugs called ATRA (All Trans-Retinoic Acid) and arsenic trioxide (ATO, Trisenox®).
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Stem cell transplant
A stem cell transplant is an intensive treatment that may increase the chances of curing AML or keep it in remission for longer. This treatment is not suitable or needed for everyone. Some people will have a donor or allogeneic stem cell transplant. Rarely, people with AML will have a stem cell transplant using their own stem cells. This is called an autologous stem cell transplant.
Most people in the UK have treatment for AML as part of research called clinical trials. Before you have any treatment, your doctor will explain your treatment plan and possible side effects. They will also talk to you about things to think about when making treatment decisions.
We understand that having treatment can be a difficult time for people. We're here to support you. If you want to talk, you can:
- Call the Macmillan Support Line on 0808 808 00 00.
- Chat to our specialists online.
- Visit our acute myeloid leukaemia (AML) forum to talk with people who have been affected by acute myeloid leukaemia (AML), share your experience, and ask an expert your questions.
Intensive treatment for AML
You may have intensive treatment that aims to cure AML. You usually have it in 2 phases:
- induction phase to get rid of the leukaemia cells in your blood and bone marrow (remission)
- consolidation phase, to get rid of any remaining leukaemia cells and reduce the risk of the leukaemia coming back.
You have some treatment as an inpatient in hospital, usually during induction. You may have to stay in hospital for a few weeks at a time. This could be longer depending on your side effects. If you have a stem cell transplant, you usually stay in hospital for several weeks.
Your doctor and nurse will talk to you about your treatment plan and what to expect.
Non-intensive treatment for AML
Non-intensive treatment uses lower doses of chemotherapy or other drugs to control AML for as long as possible. You may have non-intensive treatment if you have other medical conditions or health problems. It has less risk of serious side effects and may be easier to cope with. You may be able to have some treatments as an outpatient and go home the same day.
Where AML treatment is given
You usually have your treatment in a hospital that offers specialist treatments such as chemotherapy and stem cell transplants. These are usually larger hospitals, so you may have to travel for your treatment and appointments.
Teenagers and young adults
Some hospitals have cancer units for teenagers and young adults (TYAs). These are sometimes called TYA units. Not every hospital has these, but you may be offered the option. You may have to travel further from home to have treatment at one of these units. Other hospitals may have a ward or area for TYAs.
Having your treatment in a TYA unit means you can be with other young people. There may be a kitchen you can use or spaces to relax and meet friends. The staff are trained in looking after young people with cancer.
You might not be able to go to a hospital that has a TYA unit, or you may choose not to. This may mean you are treated on a cancer ward for adults. But you will still be referred to the specialised TYA team and offered psychological and social support from them. Your leukaemia treatment will be the same wherever you have it.
Treating AML that comes back
If AML comes back after treatment, it may be possible to have more treatment with chemotherapy and targeted or immunotherapy drugs. The aim is to get a second remission. Some people go on to have a stem cell transplant when they are in remission again.
Sometimes treatment can control the leukaemia but not cure it. The aim of treatment is to reduce any symptoms and improve quality of life for as long as possible.
Making treatment decisions
Treatment for ALL usually has to start quickly. If you do not feel ready to make a decision about your treatment, ask your doctor how long you can have to think about it.
Your doctor needs to make sure you have all the information you need to make your decision. You need to understand all your treatment options and what will happen if you do not have the treatment.
It can help to talk to your family or friends. You and your doctor can then decide together on the best treatment plan for you.
Benefits and disadvantages of treatment
Treatment for leukaemia has possible benefits but also possible risks.
Treatment that aims to cure the leukaemia may involve some disadvantages such as:
- longer stays in hospital – usually for several weeks at a time
- short-term side effects that may need treatment
- a risk of permanent side effects such as infertility.
Many people decide to have this treatment because the chance of curing the leukaemia outweighs these disadvantages. But there is still a risk the leukaemia may not be cured.
Some people will have treatment that aims to control the leukaemia rather than cure it. This means lower doses of chemotherapy and a lower risk of side effects. It may also mean less time in hospital. This means it may be more suitable for people who:
- are not fit enough to cope with more intensive treatment
- do not want the risks of more intensive treatment.
But with this treatment, the leukaemia is less likely to go into remission or stay in remission.
Always talk to your doctor or nurse about any concerns you have, so they can give you the best advice.
We have more information about making treatment decisions.
About our information
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References
Below is a sample of the sources used in our acute myeloid leukaemia (AML) information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk
Heuser M et al. Acute myeloid leukaemia in adult patients: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology, 2020, vol 3, issue 6. Available from www.esmo.org/ [accessed 2021].
NICE (National Institute for Health and Care Excellence). Blood and bone marrow cancers. Available from https://pathways.nice.org.uk/pathways/blood-and-bone-marrow-cancers [accessed August 2021].
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Reviewers
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Anne Parker, Consultant Haematologist.
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