Childhood Leukemia Overview

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Treating Leukemia in Children TOPICS

Treatment of children with acute myeloid leukemia

Treatment for most children with acute myeloid leukemia (AML) is in 2 phases:

  • Induction
  • Consolidation (intensification)

Compared to treatment for ALL, the treatment for AML uses higher doses of chemotherapy (chemo) but for a shorter time. Treatment is very intense and there is a risk of serious complications, so children with AML need to be treated in cancer centers or hospitals that have a lot of experience with this disease.

Induction

The combinations of drugs used to treat AML are different from those used for ALL. Treatment is given over several days. The schedule of treatment may be repeated in 10 days or 2 weeks, depending on how intense the doctor wants the treatment to be. Treatment is repeated until the bone marrow shows no more leukemia. This usually happens after 2 or 3 treatments. Often chemo is put into the cerebrospinal fluid (CSF), too. Usually radiation treatment to the brain is not needed.

Consolidation (intensification)

This phase begins after a remission when no more leukemia cells are seen in the bone marrow.

Some children have a brother or sister who would be a good stem cell donor. For these children, a stem cell transplant is often recommended. For children with good prognostic factors, some doctors recommend just giving high-dose chemo and holding off on the stem cell transplant in case the AML comes back after treatment.

For other children, high-dose chemo is given for at least several months. Chemo into the cerebrospinal fluid is usually given at the start and every 1 to 2 months for as long as this phase lasts.

An important aspect of treatment for AML is supportive care (nursing care, nutrition, antibiotics, blood transfusions, etc.). With this care, a high rate of remission can be achieved.

Treatment of refractory or recurrent AML

Less than 15% of children have refractory AML (leukemia that does not respond to initial treatment). These leukemias are often very hard to cure, so the doctor may recommend a stem cell transplant if it can be done.

As a rule, the outlook for a child whose AML comes back after treatment is slightly better than if a remission were never achieved. But this depends on how long the first remission lasted. The chance of a second remission is better if the first one lasted for at least a year, but long-term second remissions are rare without a stem cell transplant.

Most children whose leukemia has come back will be offered a clinical trial in the hope that if a remission is brought about, a stem cell transplant can then be done. Sometimes the doctor may suggest a stem cell transplant even without a remission.

If you’d like information on a drug used in your child’s treatment, see our Guide to Cancer Drugs, or call us with the names of the medicines your child is taking.


Last Medical Review: 11/11/2013
Last Revised: 02/03/2014