Therapy Phases for AML
Acute myelogenous leukemia (AML) treatment usually involves two phases of treatment: remission induction therapy and consolidation, or post-remission, therapy.
Remission Induction Therapy
This first phase of chemotherapy treatment is designed to bring about complete remission (bone marrow contains less than five percent leukemia cells) and usually lasts for one week. Sometimes more than one course of induction therapy is needed to bring about complete remission.
Because of a tendency to bleed, patients with the subtype acute promyelocytic leukemia (APL) usually receive multiple transfusions of platelets and other factors that help the blood to clot. Typically, induction therapy for APL includes chemotherapy drugs and a non-chemotherapy drug called all-trans retinoic acid (ATRA). This combination results in complete remission in a high percentage of patients with APL.
Also known as post-remission therapy, consolidation therapy is designed to kill any remaining leukemia cells. The treatments available for consolidation therapy include one to two courses of high-dose chemotherapy using only ara-C, or a hematopoietic cell (stem cell or bone marrow) transplant. Without this additional therapy, most patients will experience a relapse of their disease.
Consolidation therapy for patients with the APL subtype usually consists of two or more courses of an anthracycline chemotherapy drug and ATRA or arsenic trioxide. The ATRA and arsenic may be continued for six months to a year after the chemotherapy courses have ended.