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How We Treat Childhood Acute Myeloid Leukemia (AML)

  • There are a number of treatments for childhood AML. Some help to treat the leukemia, while others are intended to address complications of the disease or side effects of the treatment. Your child's physician will determine a specific course of treatment based on several factors, including:

    • Your child's age, overall health, and medical history
    • The type of AML your child has
    • Specific aspects of the AML, such as:
      • the number of white blood cells in the blood when the leukemia is diagnosed
      • whether leukemia cells are seen in the spinal fluid
      • whether specific chromosomal abnormalities are found in the leukemia cells
    • How well the leukemia responds to the first few weeks of treatment
    • Your child's tolerance for certain medications, procedures, or therapies
    • Whether your child has Down syndrome
    • How your child's physician expects the disease to progress

    Treatment usually begins by addressing your child's symptoms, such as anemia, bruising, and/or fever. In addition, treatment may include the following (alone or in combination):

    • Chemotherapy is a drug treatment that interferes with the cancer cell's ability to grow or reproduce. For some types of cancer, chemotherapy is used alone, while in others it is used in conjunction with other therapy, such as radiation therapy or surgery.
    • A stem cell (bone marrow) transplant involves the replacement of diseased bone marrow with another person's healthy bone marrow.
    • Medications may be given to prevent or treat damage to other systems of your child's body caused by leukemia treatment, or for nausea and side effects of treatment.
    • Blood transfusions are given to replace or supplement your child's red blood cells and platelets.
    • Antibiotics may be given to prevent or treat infections.

    Your child's health will be closely monitored to determine response to treatment, detect recurrent disease, and manage late effects of treatment.

    Treatment Phases in Childhood AML

    In general, phases in the treatment of AML include:

    Phase 1: Induction

    Induction is the first phase of treatment. It is a combination of chemotherapy and medications given to stop the growth of abnormal cells in the bone marrow. The goal of this phase is to induce the cancer to go into remission. Remission occurs when leukemia cells are no longer visible under the microscope in either bone marrow or blood.

    The induction phase may last approximately one month and is usually followed by a second course of induction treatment, regardless of whether a remission is achieved. It can be repeated if remission is not achieved.

    Even when remission is achieved, leukemia may still be present in the body, which is why further therapy is necessary.

    Phase 2: Intensification or consolidation

    Intensification or consolidation is continued treatment to eliminate any leukemia cells remaining after induction. In some cases, further chemotherapy is recommended, while in other cases a stem cell transplant may be recommended. Your care team will work with you to determine the best course of treatment.

    Clinical Trials in Childhood AML

    Research is a top priority at Dana-Farber/Boston Children's, and our physicians work continuously to translate laboratory findings into clinical therapies.

    Research from Dana-Farber/Boston Children's and the Broad Institute of Harvard and MIT integrates sophisticated interdisciplinary approaches to solve a molecular mystery that may lead to alternative therapeutic strategies for AML. This study identifies a previously unrecognized AML target that responds well to pharmacological inhibition and may be an excellent candidate for use in future clinical trials.

    Learn more about clinical trials for pediatric cancer.

    Long-term Outlook for Children Treated for AML

    Your child's AML prognosis greatly depends on:

    • Genetic abnormalities and other features of the leukemia
    • The cancer's response to treatment
    • Your child's age and overall health
    • Your child's tolerance of specific medications, procedures, or therapies

    Relapse can occur during any stage of treatment, even with aggressive therapy, or may occur months or years after treatment has ended. Overall, between 60 and 70 percent of children treated for AML will be long-term survivors; for some specific types, the survival rate exceeds 80 percent.

    As with any cancer, prognosis and long-term survival can vary greatly. Prompt medical attention and aggressive therapy are important for the best prognosis, and continuous follow-up care is essential. New methods are continually being discovered to improve treatment and decrease side effects that may result from treatment.

    Survivorship care is important for patients with AML in remission. Our pediatric cancer survivorship programs, which set the national standard for childhood cancer survivorship care, offer ongoing care to manage late effects caused by your child's cancer or the treatment received.