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Acute Myeloid Leukemia (AML) in Adults
The goal of treatment for acute myeloid leukemia (AML) is to put the leukemia into complete remission (the bone marrow and blood cell counts return to normal), preferably a complete molecular remission (no signs of leukemia in the bone marrow, even using sensitive lab tests), and to keep it that way.
About 2 out of 3 people with AML who get standard induction chemotherapy (chemo) go into remission. This usually means the bone marrow contains fewer than 5% blast cells, the blood cell counts return to within normal limits, and there are no signs or symptoms of the disease. The actual chance of remission depends to a large part on a person’s specific prognostic factors, such as their age and the presence of certain gene or chromosome changes in the leukemia cells.
For example, older people generally don’t do as well as those younger than 60. They often have trouble tolerating intensive treatment and often have chromosome changes in leukemia cells that are linked to a poorer outlook. About half of these patients go into remission after initial treatment.
If remission is achieved, patients typically get more chemo (consolidation) to try to get rid of any remaining leukemia cells. Up to half of patients who get consolidation go into long-term remission (and may be cured). But this number is also affected by prognostic factors, such as a person’s age and whether the leukemia cells have certain gene or chromosome changes. Using an allogeneic stem cell transplant as consolidation has a higher success rate, but it also has a higher risk of death as a complication.
The outlook for people with acute promyelocytic leukemia (APL) tends to be better than for those with other types of AML, although again prognostic factors can be important. About 9 out of 10 people with APL will go into remission with standard induction treatment. With consolidation and maintenance, about 8 or 9 out of 10 people with APL stay in long-term remission.
The American Cancer Society medical and editorial content team
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
Appelbaum FR. Chapter 98: Acute leukemias in adults. In: Niederhuber JE, Armitage JO, Dorshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 5th ed. Philadelphia, Pa. Elsevier: 2014.
Kebriaei P, de Lima M, Estey EH, Champlin R. Chapter 107: Management of Acute Leukemias. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2015.
Larson RA. Initial treatment of acute promyelocytic leukemia in adults. UpToDate. 2018. Accessed at www.uptodate.com/contents/initial-treatment-of-acute-promyelocytic-leukemia-in-adults on June 25, 2018.
Larson RA. Post-remission therapy for acute myeloid leukemia in younger adults. UpToDate. 2018. Accessed at www.uptodate.com/contents/post-remission-therapy-for-acute-myeloid-leukemia-in-younger-adults on June 25, 2018.
National Comprehensive Cancer Network. NCCN Practice Guidelines in Oncology: Acute Myeloid Leukemia. V.1.2018. Accessed at www.nccn.org/professionals/physician_gls/pdf/aml.pdf on June 25, 2018.
Last Revised: August 21, 2018
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