TREATMENT OF ACUTE MYELOID LEUKEMIA (AML)
Treatment is carried out in two parts
i) Remission induction
ii) Post remission /consolidation therapy
The rationale of going on with therapy beyond the point of complete remission (CR) is that at the this point when there is no morphologically detectable leukemia, there ae still about 10^8 or 10^9 leukemic blast cells present and if post remission treatment is foregone, majority of patients develop recurrent leukemia.
1) Remission induction therapy- a cytotoxic antibiotic(anthracyclines) such as doxorubicin or daunorubicin is given together with an antimetabolite such as cytarabine (cytosine arabinoside) with or without another drug such as etoposide (antitumor agents)
During this treatment the patient stays in hospital for at least 4 weeks due to the risk of infection and bleeding that’s due ti the neutropenia and thrombocytopenia. The subsequent treatments are given on outpatient basis.
During this treatment the patient stays in hospital for at least 4 weeks due to the risk of infection and bleeding that’s due ti the neutropenia and thrombocytopenia. The subsequent treatments are given on outpatient basis.
2) Post remission therapy- there are several suggested regimens that include
a) Further cycles of the chemotherapy used to induce remission
b) Ay other chemotherapy different from that used to induce remission
c) Bone marrow transplant (myeloablative therapy)
Treatment for recurrence
Second remissions are difficult to achieve and thus treatment is depended upon the state of the patient. Younger patients undergo bone marrow transplant in the event the secondary remission is achieved. In older patients, a more intensive chemotherapy is considered and when its not safe, palliative care is given instead.
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