If you’re diagnosed with acute myeloid leukemia (AML), you’ll need to start treatment right away. That’s not an exaggeration.
“If you're on vacation, your doctor is going to tell you to get on the next plane and come back, because this is a disease that cannot wait,” says Lore Gruenbaum, PhD, senior vice president and chief scientific officer at Blood Cancer United.
The sooner you’re diagnosed and treated, the better your outcome will be. Here’s what else to know about treatment for this fast-growing cancer.
Why Is Quick Treatment Needed for AML?
Like many blood cancers, acute myeloid leukemia causes the blood cells that usually help you function “go rogue,” Gruenbaum says.
These abnormal cells then start to divide very rapidly, crowding out healthy blood cells in your bone marrow, where the key cells in your blood are made.
As a result, you’ll begin to lose healthy red blood cells that transport oxygen throughout your body and help you breathe, platelets that clot your blood, and white blood cells that work to prevent infection.
“This happens very, very quickly,” Gruenbaum says. “It can lead to very severe symptoms and a very dangerous situation within just a few weeks.”
Why can an AML diagnosis take so long?
Early AML symptoms can be mild and overlap with many different conditions.
“You're tired, you have bruises, you've got headaches, maybe you've got this cold that you can’t get rid of because your white blood cells aren't functioning well,” Gruenbaum says.
Your doctor may need to rule out a lot of other conditions and order tests before they can make a diagnosis. Once they do, “they're going to absolutely call you up,” Gruenbaum says.
Testing After AML Diagnosis
AML is a little different for everyone who has it. After your diagnosis, your doctor will likely take samples of your blood and bone marrow to look for “weak spots” in the type of cancer you have.
“We call these ‘molecular mutations,’ but it just means that there's something that sticks out that's different from a healthy cell,” Gruenbaum says.
What Does AML Treatment Include?
Acute myeloid leukemia is often treated with chemotherapy to clear the cancer cells from your body. It’s given to you through an IV (a vein in your arm.)
Chemotherapy phases
You’ll get chemotherapy in different phases.
Remission induction therapy. First, you’ll be treated with intense chemotherapy. Because this will weaken your immune system and put you at high risk for infections, you’ll spend time afterward in an isolated “clean room” in a hospital.
Consolidation therapy. After you reach remission (when no cancer cells are detected in your blood or bone marrow) you’ll have more chemotherapy. This can target any leftover cancer cells that could start to grow.
You may get this chemotherapy five days each month for three to four months.
Maintenance therapy. In some cases, your doctor may also prescribe low-dose chemotherapy for months or years.
Other AML treatments
Other AML treatments include:
Targeted therapy
Newer drugs can target specific genetic mutations (changes) that can be identified through testing. You could get targeted therapy at the same time as chemotherapy since it may help the chemotherapy work better.
Your doctor could also prescribe a targeted treatment if chemotherapy doesn’t work well for you.
Some targeted medications are tablets that you take by mouth. Others are given to you by IV.
Allogeneic stem cell transplant
After high-dose chemotherapy, you could go into the hospital to get an infusion of healthy stem cells. Usually, these come from a donor’s blood or bone marrow. They allow your body to make new blood cells and fight any leftover cancer cells that may be hiding in your body.
The stem cell transplant process is usually quick and painless. You’ll get the stem cells through an IV, much like a blood transfusion. But it can take two to three weeks for healthy new blood cells to grow inside your body. During this time, you’ll be monitored closely for side effects in the hospital.
A stem cell transplant is the only way to cure AML. But because the process is complex and the side effects can be severe, not everyone who is diagnosed with AML is able to have one.
Goals of AML Treatment
Your doctor will try to help you reach remission, which means that no cancer cells can be found in your blood or bone marrow.
“Then, we very much hope and work on keeping you in remission as long as possible, so that you won't need another treatment — hopefully for a long time,” says Gruenbaum.
What Else to Know About Acute Myeloid Leukemia Treatment
As you prepare for AML treatment, keep in mind that:
Your treatment may be delayed to do more testing.
After you go into the hospital, your doctor may decide to postpone your treatment another day or two to do more testing. “That's not a reason to freak out,” says Gruenbaum. It likely means that your doctor is up to date on the latest treatments and wants to see if one could treat the type of AML that you have.
You’ll have more than one doctor.
“There's going to be a whole team to support you,” says Gruenbaum. As well as the doctor who diagnosed you and the doctor who treats you, your care team could include a:
- Hematologist-oncologist who specializes in AML
- Oncology nurses, to help with your chemotherapy
- Pharmacist, who can advise you about your medications
- Nutritionist, to make sure you keep eating healthy foods
- Social worker, who can guide you through the health care system, provide counseling, and steer you toward more support
You may feel worse before you feel better.
You might not have had a lot of symptoms when you were diagnosed with AML. After starting intensive chemotherapy, you’ll probably start to feel noticeably sicker.
“That is, unfortunately, part of the treatment,” says Gruenbaum. “It’s important to know that’s probably going to happen. But it means that we're getting ahead of the cancer.”
Your care team will have medications and other strategies to help you manage any side effects.
You have more support than you may realize.
It’s common to have a lot of questions and concerns after an AML diagnosis. Your doctor is there to support you. So are blood cancer-focused nonprofits like Blood Cancer United.
Without any cost to you, you can find patient and caregiver resources, get financial assistance, join an online community, and talk to a trained peer volunteer who lives with your same diagnosis and is further along in treatment.
“It can be reassuring to have someone tell you, ‘Look, I went through the same thing, and here's what I learned,” Gruenbaum says.
AML treatment keeps getting better.
Over the last decade, experts have made a lot of progress in better understanding and treating AML. Important research is ongoing. “Even if we don't have a cure or a super effective treatment for you today, we may have it tomorrow or next year,” says Gruenbaum.
Show Sources
Photo Credit: Maskot/Getty Images
SOURCES:
Lore Gruenbaum, PhD, senior vice president and chief scientific officer, Blood Cancer United.
National Cancer Institute: “Acute Myeloid Leukemia Treatment (PDQ ®)—Patient Version.”
Cleveland Clinic: “Acute Myeloid Leukemia (AML).”
Blood Cancer United: “Acute Myeloid Leukemia (AML),” “Peer-to-Peer Support.”
Journal of Hematology & Oncology: “Recent advances in targeted therapies in acute myeloid leukemia.”
Mayo Clinic: “How an Oncology Social Worker Can Help.”
American Cancer Society: “Targeted Therapy Drugs for Acute Myeloid Leukemia (AML),” “Stem Cell Transplant for Acute Myeloid Leukemia for AML.”
Cancer Research UK: “Targeted cancer drugs for acute myeloid leukemia (AML.)”
University of Chicago Medicine: “The Stem Cell Transplant Process.”
