Treatment for acute myeloid leukemia (AML) is usually coordinated by a cancer care team, headed by a hematologist or medical oncologist.

There are a variety of methods used to treat AML. The exact treatment method chosen for each patient depends on the subtype of the leukemia as well as certain prognostic factors including the patient's age, white count and general medical status.

Patients with AML usually are treated immediately and aggressively in order to destroy the leukemia cells in the blood and bone marrow and put the leukemia in remission. AML treatment is divided into two phases and the first is known as remission induction therapy. After the signs and symptoms of the disease disappear, additional therapy may be given to destroy any undetected leukemia cells and prevent a relapse. This is known as postremission therapy or consolidation therapy.

Because leukemia is a blood disorder and does not form tumors, surgery is not a form of treatment. Common treatment methods for AML include:

• Chemotherapy. Uses powerful anti-cancer drugs to destroy cancer cells. When used to treat AML, a combination of drugs may be used. Chemotherapy is usually the main treatment method for AML. A plastic tube called a venous access device may be inserted into a patient’s vein for chemotherapy. This provides easier access for drug delivery and allows blood samples to be removed without repeated needle sticks.
  
  
• Radiation therapy. Uses high-energy rays to destroy cancer cells and shrink tumors. It may be ordered to treat leukemia that has spread to the brain, spinal fluid or testicles. Radiation therapy may be ordered before a patient undergoes a bone marrow or peripheral blood stem cell transplantation. On rare occasions, radiation treatment may be ordered as an emergency treatment to reduce the size of a mass pressing on the trachea.
  
  
• Monoclonal antibodies. Proteins made in a laboratory that can be designed to attach to certain molecules on the surface of AML cells. When injected into a person with leukemia, the antibodies destroy the cancer cells. Monoclonal antibodies may be bound with a radioisotope or cell toxin to increase effectiveness. It may be used to treat older AML patients who have relapsed after initial chemotherapy and may not be able to tolerate further chemotherapy. Research continues into the use of monoclonal antibodies as treatment for leukemia patients.
  
  
• Bone marrow/stem cell transplantation. Transplantation of bone marrow cells or peripheral blood stem cells. The stem cells may come from a matched donor or from the patients themselves. This is not a direct treatment for cancer, but helps the body to tolerate higher levels of chemotherapy, radiation therapy or a combination of both. In addition to destroying cancer cells, high dose therapies also destroy normal blood cells in the bone marrow. Patients who undergo transplantation receive an infusion of healthy stem cells through a vein after high-dose therapies. As a result of the infusion, new blood cells begin to develop from the transplanted cells. This procedure is complex and cannot be used with all patients.

Treatment of the M3 subtype of AML (acute promyelocytic leukemia [APL]) differs from the treatment of other subtypes because patients with APL may develop serious blood-clotting or bleeding problems. Anticoagulants (medicines that thin the blood) may be prescribed to prevent or treat these disorders. Other treatment options include transfusions of platelets or other blood products. Overall, induction therapy is successful in approximately 65 percent of all AML patients.

There are a number of terms that may be used to describe the status of AML following treatment. These terms include:

• Relapse (recurrence). The return of leukemia after the initial treatment is known as relapse. A patient with more than five percent blast cells present in the bone marrow may be classified as being in relapse.
  
  
• Remission. Following treatment AML may be classified as being in remission when:
  
  
• The complete blood count is normal.
  
  
• There are less than 5 percent blast cells in the bone marrow.
  
  
• There are no signs or symptoms of the disease detected anywhere in the body.
  
  
• Active disease. In a patient who is newly diagnosed or in relapse, AML will be classified as active disease.
  
  
• Minimal residual disease. This term is used to describe a case of AML when there is molecular evidence that cancer cells remain in the bone marrow, but there are not enough of the cells to be detected by routine examination under a microscope.

Following treatment, patients typically require regular visits to their physician for several years. Frequent checkups enable the physician to detect any changes in health and provide immediate treatment. Checkups may include a physical examination, x-rays, blood tests, and other lab tests. In most cases, a CBC and often a repeat bone marrow are included to monitor the disease.

Patients are encouraged to report the development of any new symptoms to their physician. They may be a sign of recurrent AML or side effects of treatment. The disease can return in the blood, bone marrow, or other parts of the body. It is unusual for AML to return when there are no signs of the disease five years after treatment.

According to the American Cancer Society (ACS), the overall AML survival rate in adults under age 65 is approximately 33 percent. For patients over age 65, the 5-year survival rate is about 4 percent. However, it is less likely that patients over 65 will receive intensive anti-leukemia therapy because of concurrent serious medical conditions or patient choices.