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How We Treat Acute Myeloid Leukemia

  • Experimental drug improves survival in certain AML patients
    Dana-Farber's Richard Stone, MD, discusses the drug midostaurin, which, added to standard chemotherapy is the first targeted treatment to improve survival of a high-risk, genetically defined subgroup of patients with acute myeloid leukemia.

  • Our Unique Approach

    The Adult Leukemia Program is part of Dana-Farber/Brigham and Women's Cancer Center's Center for Hematologic Oncology, one of the world's largest and most respected treatment centers for patients with blood or bone marrow disorders.

    Your care will involve the latest treatments currently available, combined with new therapies based on research in our laboratories and elsewhere in the field of leukemia treatment. You also have the full range of support services from a top-ranked hospital and leading cancer research center.

    Team Approach

    You receive world-class care from specialists with years of expertise in caring for adults with AML. These experts, including hematological oncologists, physician assistants, nurse practitioners, and infusion room nurses, manage your care as a team in order to decide what approach will best treat your condition at each stage. We work closely with our transplant service team when patients require bone marrow/stem cell transplantation. We have extensive experience in standard and emerging therapies, and in monitoring the disease at a molecular level to ensure that your care plan offers the best possible outcomes.

    Personalized Treatment

    As a highly specialized Center within DF/BWCC's Center for Hematologic Oncology, we focus on the distinct needs of patients with leukemia. We provide a very personalized approach to your care.

    We view every patient as an individual with unique needs and expectations. We take time to involve you and your family in each step of the treatment process. As you go through treatment, you and your family will have access to a wide range of support resources — from nutrition services to integrative therapies.

    Specialized Care for Older Adults

    Geriatricians in our Older Adult Hematologic Malignancy Program work closely with our oncologists to create individualized treatment plans for older patients. These plans consider other illnesses or concerns that affect older adults in particular.

    Offering Expertise through Consultations and Second Opinions

    • Because adult acute myeloid leukemia is a quickly progressing blood cancer, there is great value in patients with suspected or diagnosed AML consulting with our team, which has deep experience in treating patients with this disease.
    • We routinely evaluate specimens sent to us from outside centers. These specimens are evaluated by our entire team, including our hematopathologists.

    Reasons to consider a consultation or second opinion include:

    • To confirm your diagnosis.
    • If you have received a diagnosis elsewhere and want to be treated at Dana-Farber/Brigham and Women's Cancer Center.
    • To determine the optimal therapy and timing of treatment.
    • To learn more about your cancer from specialists who are world leaders in this disease, and who have treated hundreds of other patients like you.
    • To learn if you're eligible for a clinical trial.

    Phone: 617-632-6028 or 617-632-5138
    Online: Complete the Appointment Request Form

    If you cannot travel to Boston in person, you can take advantage of our Online Second Opinion service.

    For Referring Physicians

    Because you, the referring physician, are an integral part of your patient's care team, we are committed to collaborating with you to provide the best care for your patient.

    If you are a physician and have a patient with diagnosed or suspected AML, we look forward to working with you. Learn how to refer a patient.

    Our Treatment Approach

    Treatment for AML is a long-term process. Chemotherapy and other treatment for the disease may take 6 to 12 months to complete.

    The treatment of adult AML is usually done in phases:

    Remission Induction Therapy
    Some, but not all, patients are eligible for induction therapy. In this phase, several chemotherapy drugs are given during 4 to 6 weeks of inpatient treatment, with the goal of destroying as many cancer cells as possible to achieve a remission. Sometimes, more than one course of induction therapy is needed. If patients go into remission, we look at molecular and chromosomal tests to see if a stem cell transplant would be beneficial to maintain the remission. Patients may continue with chemotherapy while moving to the transplant stage.

    Post-Remission Therapy (also called consolidation therapy)
    Even after remission is achieved, leukemia cells are still present in the body, which is why further therapy is necessary.

    The goal of consolidation therapy — which typically lasts 6 to 7 months — is to kill remaining leukemia cells that may not be active but could begin to regrow, usually using chemotherapy. Patients may be hospitalized for parts of this phase of treatment.

    If your disease has relapsed after having achieved a remission, our clinicians will meet with you to discuss standard treatment options as well as clinical trials, with the goal of achieving a second remission.

    We also have special protocols for older patients through our Older Adult Hematologic Malignancy Program for patients who may benefit from a less intensive, though still beneficial, treatment regimen.

    Treatment of AML may also include the following:

    Stem Cell Transplant
    Some patients, including older adults who would not benefit from intensive initial chemotherapy, may benefit from an allogeneic stem cell transplant as part of initial treatment or as part of treatment for relapsed disease. These re-infused stem cells grow into (and restore) the body's blood cells. Dana-Farber/Brigham and Women's Cancer Center (DF/BWCC) has one of the largest and most experienced stem cell transplantation programs in the country.

    Targeted Therapy
    Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. Targeted therapy may target a specific mutation in a cancer cell or help stimulate the immune system to attack the cancer.

    In 2017, a targeted drug whose clinical testing was led by Richard Stone, MD, (program director of the Adult Leukemia Program at Dana-Farber), became a new treatment for newly diagnosed AML. The drug, midostaurin (Rydapt®), was approved by the FDA as a combination treatment with chemotherapy for adult patients newly diagnosed with AML with a mutation in the gene FLT3.

    Other Drug Therapy
    Arsenic trioxide and all-trans retinoic acid (ATRA) are anticancer drugs that kill leukemia cells, stop the leukemia cells from dividing, or help the leukemia cells mature into white blood cells. These drugs are used in the treatment of a form of AML called acute promyelocytic leukemia (APML).

    Investigational Approaches

    The Adult Leukemia Program operates a large and growing research program. We are actively engaged in leukemia clinical trials, leading to new therapies and aiming for eventual cures.

    Patients also have access to trials at other Harvard-affiliated institutions, those sponsored by private industry, as well as those that are part of a collaborative effort, such as Harvard's Alliance for Clinical Trials in Oncology, of which our program is a member.

    Your Care

    You will be assigned to one of our leukemia physicians as your primary oncologist overseeing all aspects of your care, both inpatient and outpatient.

    All outpatient therapy is provided at the Yawkey Center for Cancer Care at Dana-Farber Cancer Institute, one of the most advanced outpatient cancer centers in the country.

    If you need to be hospitalized during your care, or if you undergo stem cell transplantation, you will be admitted to Brigham and Women's Hospital (BWH) or the Dana-Farber Inpatient Hospital located within BWH. Your primary oncologist and nurse will closely monitor your care and will coordinate your care with the inpatient team and additional specialists, who will address any other symptoms you may be experiencing. This model ensures seamless care from the outpatient to the inpatient setting. Learn more about your stay.