If you or a loved one is facing acute myeloid leukemia (AML), understanding the treatment options and advances can provide clarity and confidence in the journey ahead. Here’s an overview of the primary treatments available for AML, including new and emerging therapies.

AML treatment is divided into 2 phases:

1. Remission Induction Therapy: The goal is to eliminate leukemia cells in the blood and bone marrow to achieve remission.

2. Post-Remission (Consolidation) Therapy: After remission, this phase aims to eradicate any remaining leukemia cells to prevent relapse.

Systemic Therapy

Systemic therapy treats AML throughout the body and includes chemotherapy, targeted therapy, and immunotherapy. It can be used alone or combined with other treatments. Before starting treatment, it’s important to discuss your goals and preferences with your care team. Many patients receive systemic therapy through a catheter or port, which helps deliver medications, fluids, and blood products.

Chemotherapy

Chemotherapy is the standard treatment for AML. It kills cancer cells, but also affects healthy cells, leading to side effects that will be closely monitored. Chemotherapy is often given in cycles to allow your body to recover between treatments. Several types of chemotherapy drugs are available, and combinations are frequently used to maximize effectiveness. Common drugs include:

• Cytarabine
• Daunorubicin
• Midostaurin

Targeted Therapy

Targeted therapies focus on the specific features of leukemia cells, making them more precise than traditional chemotherapy. These therapies block molecules that allow cancer cells to grow. Your care team will tailor targeted therapies to your specific genetic profile. Some targeted therapies include:

• Gilteritinib for FLT3 mutations
• Ivosidenib for IDH1 mutations
• Venetoclax, a less-intensive option for patients who cannot tolerate strong chemotherapy

Hematopoietic Cell Transplant

A hematopoietic cell transplant (HCT), also called a stem cell or bone marrow transplant, replaces the damaged bone marrow with healthy cells. This is a major treatment for AML, particularly after chemotherapy has destroyed the diseased cells. Donor stem cells help rebuild the bone marrow and create new, healthy blood cells. The process requires careful preparation, including conditioning with chemotherapy to make room for the new cells. Recovery can take weeks, but this treatment can lead to long-term remission.

Clinical Trials and New Treatments

Advances in AML treatment are constantly being explored. Clinical trials test new drugs, combinations, and approaches that could improve outcomes for patients with AML. These trials are conducted in phases to ensure safety and effectiveness before becoming widely available. Always talk to your doctor to see if a clinical trial may be right for you.

Supportive Care

Throughout your treatment, supportive care will help manage symptoms and improve your quality of life. Whether through pain management, palliative care, emotional support, or practical assistance, your care team will work with you to ensure your well-being.

AML treatment continues to evolve, with new therapies providing hope and options for patients. Stay informed, ask questions, and work closely with your care team to choose the best approach for your condition.

References

MDS Foundation. Treating AML. Accessed December 1, 2024. https://www.youandaml.com/en-aml/view/m401-s04-treating-aml-slide-show

National Cancer Institute. Acute Myeloid Leukemia Treatment (PDQ®)–Patient Version. Updated October 15, 2024. Accessed December 1, 2024. https://www.cancer.gov/types/leukemia/patient/adult-aml-treatment-pdq

National Comprehensive Cancer Network (NCCN). NCCN Guidelines for Patients. Acute Myeloid Leukemia. 2024. Accessed December 1, 2024. https://www.nccn.org/patients/guidelines/content/PDF/aml-patient.pdf