Acute Myeloid Leukemia (AML) Treatment

Penn hematologists and medical oncologists are part of large multidisciplinary teams whose approach to cancer and blood disorders is to treat the entire individual, not just the disease.

A hematologist is a physician who specializes in blood diseases and disorders in blood-forming organs.

A medical oncologist is a physician who specializes in the diagnosis and treatment of cancer.

Certain hematologists/oncologists at Penn specialize in the diagnoses of patients with blood cancers, including leukemia.

If You Have Been Diagnosed with Acute Myeloid Leukemia (AML)

If you have been diagnosed with AML, you may undergo remission induction therapy.

People with AML are considered to be in remission if their bone marrow has no evidence of disease and their bone marrow and blood cell counts have returned to normal.

To treat AML, you may be admitted to the hospital for some time to receive therapy. Many leukemia treatments kill rapidly dividing cells, which means that both normal and abnormal cells are killed.

Because of this type of therapy, you are at a very high risk for infections, and must remain in the hospital.

Once you are in remission, your doctor may recommend additional chemotherapy and/or a bone marrow or stem cell transplant to prevent you from relapse.

The following are possible treatments for people diagnosed with acute myeloid leukemia (AML). Your treatment will depend on the subtype of your AML and its prognosis.

Chemotherapy

Chemotherapy uses drugs to attack cancer cells, slowing or stopping their ability to grow and multiply.

Chemotherapy is usually given:

  • Orally: taking pills or capsules by mouth
  • Intravenously (IV): injecting medication into a vein
  • Intramuscularly (IM): injecting medication into a muscle
  • Subcutaneously (SC): injecting medication under the skin
  • Intrathecally (IT): injecting medication into the spinal fluid 

Chemotherapy is not a "one-size-fits-all" cancer treatment.

The wide range of cancer-fighting drugs attack different types of cancer cells at varying stages of cell development.

Penn medical oncologists are experts at determining which drug or combination of drugs will be the most effective in treating the various types of cancer.

For a comprehensive list of most commonly used chemotherapy agents, please visit OncoLink.

Complications and Side Effects of Chemotherapy

Chemotherapy kills cells in the body. Standard chemotherapy treatments do not distinguish “good” cells from “bad” cells. Therefore, even healthy cells may be killed.

Because of this, people with AML who undergo standard chemotherapy are at high risk of infection. This is why hospitalization is necessary.

Other side effects from chemotherapy include:

  • Low blood counts
  • Hair loss
  • Mouth sores
  • Nausea
  • Vomiting

Learn more about managing cancer treatment side effects.

Targeted Molecular Therapy

Targeted molecular therapy at Penn Medicine is a type of personalized medical therapy designed to treat cancer by interrupting unique molecular abnormalities that drive cancer growth.

Targeted therapies are drugs that are designed to interfere with a specific biochemical pathway that is central to the development, growth and spread of that particular cancer.

Because not every cancer develops in the same way in every person, targeted molecular therapy is personalized to you and your type of cancer.

In some cancers the molecular targets are known. But in other cancers these targets are still being identified. In some cases, the same types of cancer have different molecular targets.

Identifying the molecular targets in any given patient's cancer requires working closely with pathologists to carefully analyze the cancer pathology.

Targeted cancer therapies such as targeted molecular therapy give medical oncologists a better way to customize cancer treatment. Advantages of molecularly targeted therapy include:

  • Potentially less harm to normal cells
  • Potentially fewer side effects
  • Improved effectiveness
  • Improved quality of life

Immunotherapy

Immunotherapy is designed to repair, stimulate, or enhance the immune system's responses. Your immune system helps prevent disease, but it can also play a role in preventing cancer from developing or spreading.

The goal of immunotherapy is to enhance the body's natural defenses and its ability to fight cancer. Immunotherapy often has fewer side effects than conventional cancer treatments because it uses your own immune system to:

  • Target specific cancer cells, thereby potentially avoiding damage to normal cells
  • Make cancer cells easier for the immune system to recognize and destroy
  • Prevent or slow tumor growth and spread of cancer cells

Bone Marrow and Stem Cell Transplant

Your doctor may speak with you about bone marrow and stem cell transplants.

Bone marrow and stem cell transplants can help people with AML stay in remission. 

There are three kinds of bone marrow and stem cell transplantation. /p>

  • An autologous transplant collects your own bone marrow or stem cells before the cancer treatment. After treatment, the collected cells are returned to you to replace the cells destroyed by the cancer treatment.
  • An allogeneic transplant uses donor bone marrow or stem cells to replace the cells destroyed by the cancer treatment. A series of special tests are performed to find a donor who is a match for you.
  • Cord blood transplant uses stem cells from a baby's umbilical cord immediately after being born. The stem cells are stored until they are needed for a transplant. Umbilical cord blood cells are immature and there is less of a concern for them being a match.

Your overall health, and features of your disease will affect the decision of having a transplant.

Your doctor may speak with you about an allogeneic transplant if you aren’t responding to other treatments, you’re at high risk for relapse or the anticipated benefits outweigh the risks.

Allogeneic transplants are high-risk procedures. The decision to have a bone marrow or stem cell transplant should not be taken lightly.

About Our Bone Marrow and Stem Cell Program

Our bone marrow and stem cell transplant team are the same clinicians responsible for your overall treatment and care.

Other ways our bone marrow and stem cell transplant program are unique:

  • Our program is backed by a premier bone marrow and stem cell transplant research program that continues to make history in the development of new treatments through basic science research and clinical trials.
  • We have nationally recognized experts available to provide information, care and support throughout the transplant process.
  • Our bone marrow and stem cell transplant program is one of the oldest and largest in the country, and has pioneered new therapies to treat blood cancers.
  • We have one of the few hematologic malignancy (leukemia, lymphoma and myeloma) research programs in the country that is approved and funded by the National Cancer Institute. 
  • We have a dedicated hospital unit that is completely equipped to support transplant patients. Experienced nurses who understand the medical and personal issues patients face during transplant staff the unit.
  • We serve as medical advisors for area outreach organizations, such as the Multiple Myeloma Networking Group and the Leukemia and Lymphoma Society. 

Learn more about bone marrow and stem cell transplants at the Abramson Cancer Center.

Clinical Trials

Clinical trials benefit patients with access to breakthrough therapies and treatments.

Because more and more treatments for leukemia and blood cancers are becoming available, it’s important to speak with your doctor about available clinical trials throughout your entire cancer treatment.

Cancer specialists at the Abramson Cancer Center are part of the Eastern Cooperative Oncology Group (ECOG), one of the largest clinical cancer research organizations in the nation.

With ECOG, cancer specialists from Penn are designing clinical trials to test novel therapies, new agents, or new treatment standards for people with leukemia. They also help design and participate in clinical trials for patients with leukemia.

Because our clinical trials are updated frequently, it’s important to ask your physician about clinical trials throughout your entire treatment.

Some examples of clinical trials currently offered include:

  • Testing new combinations of drugs, new agents, and using older agents in new ways. 
  • Comparing different treatment options for older patients with AML
  • Studying targeted therapies including FLT3 inhibiters, that may be able to treat patients with AML who have a mutation in the FLT3 gene, the most common mutation in those with AML.

Advantages of Clinical Trials

Being in a clinical trial offers you the opportunity to be treated with treatments, medications or agents that are not otherwise available.

It also gives you the opportunity to be treated by, and have your case reviewed by experts who are directly involved with the design of the treatment.

Selina Luger, MD, director of the leukemia program at Penn Medicine, is co-chair of the Leukemia Committee at ECOG.

Through clinical trials:

  • Diagnosing cancer has become more precise
  • Radiation and surgical techniques have advanced
  • Medications are more successful
  • Combinations of medical, surgical and radiation therapy are improving treatment effectiveness and enhancing outcomes
  • Strategies to address the late effects of cancer and its treatment have been developed to improve the quality of life

Learn more about clinical trials, frequently asked questions about clinical trials, and available clinical trials at the Abramson Cancer Center.

Integrative Oncology Services

In addition to standard treatments and clinical trials, you may wish to add additional therapies and treatments such as massage therapy, acupuncture and art therapy.

These therapies do not have curative intent, and are designed to complement standard treatments – not take their place.

Integrative Oncology Services

Our integrative oncology services can supplement traditional cancer treatments such as chemotherapy.

While conventional medicine plays a critical role in eradicating cancer, integrative medicine and wellness programs offer you and your family ways to minimize or reduce the side effects of cancer and cancer treatment, and promote healing and recovery.

We are knowledgeable of and support complementary cancer treatments.

Our cancer teams work with patients and families to integrate these supportive programs into the overall care plan, while ensuring the safety and health of patients.

Our integrative supportive services include:

  • Diet and nutrition
  • Mindfulness-based stress reduction therapy
  • Reiki therapy
  • Yoga
  • Exercise and rehabilitation