Patients suffering from Acute Myeloid Leukemia are diagnosed and categorized by age—whether the patient 60 years of age, because older patients are less resistant to the rigors of intensive treatment. There are also intrinsic biological differences in leukemic cells within different age categories. It’s not unusual for older patients to spend three or four periods in the hospital in order to complete treatment within 6 months.

The treatment plan usually consists of two phases—initial intensive therapy followed by less intensive treatments. Most intensive treatment plans consist in about an 80% remission rate, of which about 35% of the patients being under the age of 60 are cured compared to 15% of those over the age of 60.

The most successful induction therapy for younger patients (under the age of 60) consist of an anthracycline such as daunorubicin or a related drug such as idarubicin for 2-3 days, taken in conjunction with Ara-C for 7-10 days. The third drug, etoposide, is often added with patients with the subtype M4 (acute myelomonocytic leukemia) and M5 (monocytic leukemia). It is possible by adding a fourth drug, usually 6-thioguanine, the success rate may improve, but it’s in the early stages of testing. 6-Thioguanine is relatively free of side-effects and works by stopping cells from making DNA, as rapidly multiplying leukemic cells produce large quantities of DNA.

Ara-C has few known side-effects and most patients tolerate it fairly well. Occasionally, when used in higher doses it may cause sporadic seizures, but are reversible when patients stop taking the drug. Ara-C also prevents cells from making DNA.

The most important prognostic factor in younger patients appears to be the karyotype (a characteristic chromosome). Adverse features include high white blood cell count at diagnosis and an unfavorable karyotype.

Adults with Acute Myeloid Leukemia (unlike those with acute lymphoblastic leukemia) rarely harbor in sanctuary sites. Children more often have leukemic cells in the central nervous system, thus specialists prefer to treat the central nervous system with cytotoxic drugs and radiation.

Recent test show that patients with Acute Myeloid Leukemia subtype M3 (acute promyelocytic leukemia) treated with high doses of vitamin A derivative, ATRA, often achieve remission without a period of myelosuppression and bone marrow hypoplasia (underdevelopment or incomplete development of a tissue), both which occur with conventional induction therapy for acute myeloid leukemia. Most ATRA-induced remissions have a short duration, emphasizing the need to treat with conventional induction therapy following ATRA remission treatment. ATRA can induce a complete remission in most patients with APL by causing the APL-blasts to mature. ATRA causes some side-effects, ATRA syndrome which includes fever, respiratory distress, and hypotension (abnormally low blood pressure). The ATRA syndrome can be prevented by the addition of chemotherapy and/or dexamethasone.

Following successful induction, most patients receive consolidation therapy, for example daunorubicin and Ara-C. Also, more specialists are offering BMT (Bone Marrow Transplants) as an ideal consolidation therapy.

Unlike patients with Acute Lymphoblastic Leukemia, patients with Acute Myeloid Leukemia don’t benefit from maintenance therapy.