Children who have Acute Myelogeonus Leukemia (AML) are usually treated with chemotherapy and/or a bone marrow transplantation.
About 85 percent of children with AML will go into remission after chemotherapy treatment, according to the American Society of Clinical Oncology, and about 50 percent will be cured.
Before treatment begins, your child's doctor will examine his/her bone marrow for molecular markers. Certain changes to chromosomes and genes can provide important information when your doctor is planning your child's treatment. Another consideration is white blood cell count, which can be associated with unfavorable risk if over 100,000.
During chemotherapy treatment, children with AML need to be monitored closely. The way chemotherapy works, children are left with low blood counts and weakened immune systems. Children may spend several weeks in the hospital at Seattle Children's to protect them from developing infections.
Chemotherapy may be given by mouth, intravenously, or injected into the cerebrospinal fluid (CSF). Your doctor will determine which drugs to use depending on your child's health and subtype of AML.
Two Phases of Treatment
There are two phases to chemotherapy treatment for AML, Induction and Intensification chemotherapy.
Induction chemotherapy is used to put AML into remission, that is to rid the blood and bone marrow of visible leukemic blast cells. For most AML subtypes, patients are treated with an anthracycline, such as daunorubicin, doxorubicin, or idarubicin, combined with cytarabine (also called “cytosine arabinoside” or “ara-C”).
Additional induction chemotherapy may be used to rid the body of remaining cancer cells.
Postremission Therapy, also called "consolidation therapy," will be given to prevent the patient from relapsing and may include intensive chemotherapy and possibly a bone marrow transplant.
Side effects of either chemotherapy phase is hair loss, mouth sores, and nausea or vomiting. Chemotherapy may lower the body’s resistance to infection and your child may feel tired. Your child's care team will provide medications to treat these side effects and they will usually go away after chemotherapy treatment is completed.
During your child's treatment, be sure to talk with your doctor about is often the medications for treatment and side effects.
About 50 percent of children with AML are cured with standard chemotherapy. Recurrence usually depends on the subtype of AML that your child has. For children with AML subtypes with lower risks of recurrence, chemotherapy can usually be the only treatment. It's when the risk of recurrence is higher that a bone-marrow transplant is recommended.
Bone Marrow Transplant
At least 70 percent of children with AML are cured with a bone marrow transplant, especially if they receive donor cells from a brother or sister.
As doctors find more successful treatments through clinical studies, the prognosis for children with leukemia continues to improve.
Your child’s doctor and health care team will recommend a treatment plan for your child based on the subtype of AML your child has, your child’s age, and other aspects of your child’s health.