Chemotherapy is the main treatment for acute myeloid leukaemia (AML). Find out about how it is given and the possible side effects.
You will probably have to stay in hospital whilst having chemotherapy for AML. This is because:
- it's demanding treatment
- you have side effects that the hospital staff will help you with
- you might need antibiotics into a vein to treat infection
What chemotherapy is
Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. The drugs circulate throughout the body in the bloodstream.
Phases of treatment for AML
Your treatment is in two phases:
- getting rid of the AML (induction)
- treatment to stop AML coming back (consolidation)
Getting rid of the AML (induction)
The aim of induction is to destroy the leukaemia cells.
When you have treatment
You have 2 or more different chemotherapy drugs in cycles of treatment. You have treatment for a few days, then a rest period. After the rest period, you might have more treatment.
Types of chemotherapyYou usually have a combination of 2 or more chemotherapy drugs to get rid of the leukaemia cells. The 2 main drugs are:
Treatment to stop AML coming back (consolidation)
When there are no signs of the leukaemia it is in remission. You have treatment to stop it coming back (consolidation).
When you have treatment
There are different types of consolidation treatment. Your team will tell you which combination of drugs you will have and when you will have them.
Types of chemotherapyYou normally have a combination of drugs. These include:
- high dose cytarabine
Some people have high dose chemotherapy and then a bone marrow or stem cell transplant.
Treatment for APL
Acute promyelocytic leukemia (APL) is also known as AML type M3. It is treated differently to other types of AML. As well as chemotherapy you have other drugs.
Tretinoin is also called ATRA, which stands for all trans retenoic acid. It is not chemotherapy but is made from vitamin A. You might have tretinoin alongside the standard chemotherapy treatments for AML.
Tretinoin lowers the risk of bleeding from chemotherapy and makes your APL more likely to go into remission.
You take it after your leukaemia has gone into remission too, which is known as a maintenance treatment.
Arsenic trioxide is a drug that works by speeding up the death of leukaemic cells. It also encourages normal blood cells to mature properly.
You are most likely to have this treatment if your APL has not gone into remission or has come back.
Before you start chemotherapy
You need to have blood tests to make sure it’s safe to start your treatment. You have these either a few days before or on the day your treatment begins. You have blood tests before each round or cycle of treatment.
How you have chemotherapy for AML
You usually have chemotherapy directly into your bloodstream for AML.
You need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or in your arm. It stays in while you are having treatment.
You might have cytarabine as a small injection just under the skin (subcutaneously).
Treatment for AML can cause side effects.
Dietary or herbal supplements
We don't yet know much scientifically about how some nutritional or herbal supplements might interact with chemotherapy. Some could be harmful.
It is very important to tell your doctors if you take any supplements, or if you are prescribed them by alternative or complementary therapy practitioners.
Talk to your specialist about any other tablets or medicines you take while you are having active treatment.
Some studies seem to suggest that fish oil preparations might make some chemotherapy drugs work less well. If you take or are thinking of taking these supplements, talk to your doctor to find out whether they could affect your treatment.