Chemotherapy for acute myeloid leukaemia

Having chemotherapy

Chemotherapy uses drugs to kill leukaemia cells or slow their growth. Treatment protocols set out which drugs to have, how much and how often. You can find information about protocols at eviQ, although your haematologist may need to tailor the drugs to your individual situation. For AML, there are usually 2 phases of high-dose chemotherapy. Chemotherapy drugs are most commonly given as a liquid through a drip inserted into a vein (intravenous infusion). Some drugs can be given as tablets you swallow.

For more information, see Managing side effects and Chemotherapy.

Side effects

As well as killing leukaemia cells, the drugs may also damage healthy fast-growing cells, such as new blood cells or the cells in the mouth, stomach, hair and bowel. This can cause side effects such as hair loss, high risk of infection, mouth sores, body aches, nausea, vomiting, constipation or diarrhoea, skin and nail changes, memory and concentration problems, and tiredness (fatigue).

Phases of high-dose chemotherapy for AML

Chemotherapy for AML is usually given in 2 phases: induction and consolidation.

Induction chemotherapy     

• Aims to bring about remission (when the signs and symptoms of cancer reduce or disappear).
• You’ll have an intensive course of 2–4 drugs given over a week.
• The drugs are often given through a central venous access device (CVAD) inserted into a vein in your upper arm or chest. The CVAD will be inserted under a general or local anaesthetic, and then left in place throughout the induction phase.
• As the leukaemia cells die, they release a chemical called uric acid. This may build up and damage the kidneys but can be controlled with medicine and intravenous fluids.
• You will usually need to stay in hospital for 4–5 weeks to be monitored for complications of chemotherapy. Your doctor will discuss this with you in detail before starting treatment.
• You’ll have a bone marrow biopsy to check how well the treatment has worked.

Consolidation chemotherapy

• Given after remission is achieved and once you have recovered from the induction chemotherapy.
• Aims to kill any cells that may have survived induction chemotherapy and stop AML returning (relapsing).
• Over several days, you will have 2–4 chemotherapy sessions (called cycles) with rest periods in-between.
• You may be given a similar combination of drugs to those used in induction, at the same or a higher dose.
• Depending on the types of drugs used and your general health, you will usually stay in hospital for 3–4 weeks. Some people can have their consolidation treatment as an outpatient and do not need to stay in hospital.