- How is childhood leukemia treated?
- Immediate treatment of childhood leukemia
- Surgery for childhood leukemia
- Radiation treatment for childhood leukemia
- Chemotherapy for childhood leukemia
- Targeted therapy for childhood leukemia
- High-dose chemotherapy and stem cell transplant for childhood leukemia
- Treatment of children with acute lymphocytic leukemia (ALL)
- Treatment of children with acute myeloid leukemia (AML)
- Treatment of children with acute promyelocytic leukemia (APL)
- Treatment of children with juvenile myelomonocytic leukemia (JMML)
- Treatment of children with chronic myelogenous leukemia (CML)
Treatment of children with acute myeloid leukemia (AML)
Treatment for most children with acute myeloid leukemia (AML) is in 2 phases:
- 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.
The combinations of chemo drugs used to treat AML are different from those used for ALL. Treatment is given over several days, and may be 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.
This phase begins after a remission when no more leukemia cells are seen in the bone marrow. High-dose chemo is given for at least several months.
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, especially if the risk of the leukemia coming back is high. For children with lower risk AML, some doctors recommend just giving high-dose chemo and holding off on the stem cell transplant in case the AML comes back after treatment.
Chemo is usually given into the CSF 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.
The outlook for a child whose AML comes back after treatment tends to be 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.
Last Medical Review: 05/13/2015
Last Revised: 02/03/2016