Leukemia - Acute Myeloid - AML - ChildhoodLast Updated: February 06, 2012 This section has been reviewed and approved by the Cancer.Net Editorial Board, 08/11 Overview
Leukemia is a cancer of the blood. It begins when normal blood cells change and grow uncontrollably. Acute myeloid leukemia (AML) is a type of leukemia that is a cancer of the blood-forming tissue in the bone marrow. AML may also be called acute nonlymphocytic leukemia or acute myelogenous leukemia. About bone marrow and blood cells Bone marrow is the spongy, red tissue in the inner part of the large bones and is where a person’s blood cells are made. Normal immature blood cells are called blasts. Blasts mature into one of three different types of blood cells:
About AML In AML, the bone marrow makes many abnormal cancerous cells, also called blasts or myeloblasts because they look similar to normal immature blast cells. Instead of becoming normal mature blood cells, cancerous cells divide rapidly and uncontrollably. The cancerous cells are unable to mature and work like normal blast cells, and they do not die easily. Eventually, these myeloblasts fill up the bone marrow, preventing normal cells from being made, and then build up in the bloodstream. They can also invade the lymph nodes, brain, skin, liver, kidneys, ovaries (in girls), testicles (in boys), and other organs. AML cells occasionally form a solid mass or tumor, called a chloroma. Both children and adults can have leukemia. This section is about AML that occurs in children, sometimes called pediatric AML. Learn more about AML in adults. Find out more about basic cancer terms used in this section. Looking for More of an Overview? If you would like additional introductory information, explore these related items on Cancer.Net:
Or, choose “Next” (below, right) to continue reading this detailed section. To select a specific topic within this section, use the icon panel located on the right side of your screen. Statistics
In general, leukemia is the most common childhood cancer. AML is the second most common form of leukemia in children, after acute lymphoblastic leukemia (ALL). Childhood AML is most common during the first two years of life and during the teenage years. The five-year survival rate (the percentage of people who survive at least five years after the cancer is detected, excluding those who die from other diseases) for children with AML is between 50% and 70%. Cancer survival statistics should be interpreted with caution. These estimates are based on data from thousands of people with this type of cancer, but the actual risk for a particular individual may differ. It is not possible to tell a person how long he or she will live with AML. Because the survival statistics are measured in five-year intervals, they may not represent advances made in the treatment or diagnosis of this cancer. Learn more about understanding statistics. Source: American Cancer Society. Medical Illustrations
Risk Factors
A risk factor is anything that increases a person’s chance of developing cancer. Although risk factors can influence the development of cancer, most do not directly cause cancer. Some people with several risk factors never develop cancer, while others with no known risk factors do. Doctors and researchers don’t know what causes most childhood cancers, including AML. Sometimes, AML may be caused by certain genetic or environmental factors. For example, children who have Down syndrome have an increased risk of AML during the first four years of life. However, the reasons for this increased risk are not well understood. AML occurs more often in children younger than two. The number of people with AML increases again in late childhood (during the teenage years) and continues to increase throughout later adulthood. Symptoms and Signs
Children with AML may experience the following symptoms or signs. Sometimes, children with AML do not show any of these symptoms. Or, these symptoms may be caused by a medical condition that is not cancer. If you are concerned about a symptom or sign on this list, please talk with your child’s doctor. The early signs and symptoms of AML can look very much like the flu or other common childhood illnesses. Most of the signs and symptoms of AML are caused by the bone marrow making fewer normal blood cells and the buildup of cancerous AML cells. Often a child with AML will have one or more of the following symptoms:
Your doctor will ask you questions about the symptoms your child is experiencing to help find out the cause of the problem, called a diagnosis. This may include how long your child has been experiencing the symptom(s) and how often. If cancer is diagnosed, relieving symptoms and side effects remains an important part of cancer care and treatment. This may also be called symptom management, palliative care, or supportive care. Be sure to talk with your child’s health care team about symptoms your child experiences, including any new symptoms or a change in symptoms. Diagnosis
Doctors use many tests to diagnose leukemia. Some tests may also help the doctor choose the treatment that may be the most effective. Your child’s doctor may consider these factors when choosing a diagnostic test:
When a child has signs and symptoms of leukemia, the doctor will ask about the child’s medical history and perform a physical examination. In addition, the following tests may be used to diagnose AML: Blood tests. Complete blood count (CBC) and cell type (differential count) are blood tests done to count the number of each type of blood cell under a microscope and to check if they look abnormal. Bone marrow biopsy and aspiration. A bone marrow aspiration is performed if the blood test shows abnormal blood counts. For this test, a sample of bone marrow is removed from the child’s hip with a needle and examined under a microscope. The child’s skin in that area will be numbed with medication beforehand. From this test, the doctor can find out whether the child has leukemia and, if so, what type of leukemia it is. Cytochemical and immunohistochemical tests. Cytochemical and immunohistochemical tests are laboratory tests that are used to determine the exact subtype of AML (see Subtypes). In cytochemical tests, a special dye is used that stains the different types of leukemia cells differently based on the chemicals in the cells. Immunohistochemical tests for AML are used to find markers on the surface of the leukemia cells. The different subtypes of leukemia have different and unique combinations of cell surface markers. Cytogenetics. Cytogenetics is the analysis of a cell’s chromosomes (long strands of genes), including the number, size, shape, and the arrangement of the chromosomes. This examination may be used to find genetic changes in the leukemia cells. Sometimes, a chromosome breaks off and reattaches to another chromosome, which is called a translocation. Other times, part of a chromosome is missing, called a deletion. A chromosome can also be made more than once, most often called a trisomy. Some subtypes of leukemia are caused by chromosome translocations, deletions, or trisomies. Knowing if there are certain translocations may help doctors determine the AML subtype and plan the best treatment. Flourescence-in-situ-hybridization (FISH) is a way to detect chromosome changes in cancer cells and is being used more often to help diagnose and determine the subtype of leukemia. This test is done on tissue removed during a biopsy. Genetic testing. The genetics of leukemia cells can also be used to help find out if a person needs more or less chemotherapy and/or stem cell transplantation (see Treatment). People with the Flt3 (pronounced flit 3) genetic mutation, called an internal tandem duplication (ITD), and specifically those with the mutation on both variations of the gene, have a high risk that the cancer will come back after treatment. For these children and adults, the use of stem cell transplantation may increase survival when used after the first complete remission (see Treatment). Most recently, research has shown that children with two leukemia cell gene mutations called nucleophosmin-1 (NPM1) and CEBPa have a better prognosis (chance of recovery) than those without these mutations. If a child has these mutations, the doctor may recommend chemotherapy without stem cell transplantation. Learn more about what to expect when having common tests, procedures, and scans. After these diagnostic tests are done, your child’s doctor will review all of the results with you. If the diagnosis is AML, these results also help the doctor describe the cancer and determine the subtype. Learn more about the first steps to take after a diagnosis of cancer.Subtypes
AML blasts are classified based on how much they look like normal, immature bone marrow blast cells and more recently, on cytogenetics (see Diagnosis). In the recent past, AML was divided into eight major subtypes according to a system called the FAB classification scheme (using levels M0 to M7). Now, a new method of subtyping AML is used that takes into consideration the cytogenetic causes of AML. This is called the World Health Organization (WHO) 2008 classification. These subtypes include:
Treatment
The following terms are used to describe the state of disease for children with AML: Untreated AML. The child has not received any treatment except to relieve symptoms of the disease. The blood and/or bone marrow contains too many white blood cells, and the child has signs and symptoms of the disease. Complete Remission AML. There are too few cancerous blast cells in the bone marrow to tell apart from normal blasts under the microscope (fewer than 5% blasts in the bone marrow). New monitoring methods, also called minimal residual disease (MRD; cancer cells not killed by treatment) methods, that are better able to find fewer cancerous blasts, as well as better recognize cancerous blasts from normal blasts, are being used more often to determine remission. Research studies are ongoing to find out if these methods are better able to predict the chance of curing the disease. The child usually does not have any signs or symptoms of the disease when in complete remission. Partial Remission AML. The number of cancerous blast cells in the bone marrow is reduced (between 5% and 15% in the bone marrow) but still can be seen under the microscope. The child usually does not have any signs or symptoms of the disease. This happens only during initial therapy called induction (see below). Recurrent AML. The disease has come back after the child had a period of remission (complete absence of symptoms; see below). Refractory AML. The leukemia did not go into complete remission after treatment. Treatment overview In general, cancer in children is uncommon, so it can be hard for doctors to plan treatments unless they know what has been most effective in other children. That’s why more than 60% of children with cancer are treated as part of a clinical trial. Clinical trials are research studies that compare standard treatments (the best proven treatments available) with newer treatments that may be more effective. Investigating new treatments involves careful monitoring using scientific methods, and all participants are followed closely to track their health and progress. To take advantage of these newer treatments, all children with cancer should be treated at a specialized cancer center. Doctors at these centers have extensive experience in treating children with cancer and have access to the latest research. A doctor who specializes in treating children with cancer is called a pediatric oncologist. In many cases, a team of doctors treats a child with cancer; this is called a multidisciplinary team. Pediatric cancer centers often have extra support services for children and their families, such as child life specialists, nutritionists, social workers, and counselors. Special activities and programs to help your child and family cope may also be available. An increasing number of pediatric cancer centers also have services for teenagers and young adults. Sometimes, adult cancer centers also offer clinical trials for teens and young adults with cancer. Descriptions of each treatment option for AML are listed below. Two types of treatment are commonly used to treat AML in children: chemotherapy and stem cell/bone marrow transplantation. Radiation therapy is occasionally used in specific situations. Sometimes, more than one treatment is used. Treatment options and recommendations depend on several factors, including the subtype of AML, possible side effects, and the patient’s preferences and overall health. Learn more about making treatment decisions. Chemotherapy Chemotherapy is the most common treatment for AML. It is the use of drugs to kill cancer cells, usually by stopping the cancer cells’ ability to grow and divide. Systemic chemotherapy is delivered through the bloodstream to reach cancer cells throughout the body. It is given by a pediatric oncologist or hematologist, a doctor who specializes in treating blood disorders. A chemotherapy regimen (schedule) usually consists of a specific number of cycles given over a set period of time. A patient may receive one drug at a time or combinations of different drugs at the same time. Several treatment regimens have been developed that involve intensive use of several drugs. Following these regimens, about 85% of children will have an initial remission, and about 50% will be cured (meaning that the cancer never returns). During treatment, children with AML need to be monitored very carefully and often spend many weeks in the hospital because very low blood cell counts increase the risk of developing infections. Chemotherapy may be given by mouth, injected into a vein, or injected into the cerebrospinal fluid (CSF) that circulates around the brain and spinal cord. The choice of drugs depends on whether the child has previously been treated for AML, as well as other factors. Chemotherapy for AML is usually divided into two phases of treatment: induction and intensification. Induction chemotherapy uses chemotherapy to kill as many of the cancer cells as possible to make the AML to go into remission. Intensification chemotherapy is used to kill any cancer cells remaining after induction chemotherapy. Stem cell transplantation also can be used for intensification therapy (see below). The side effects of chemotherapy depend on the individual and the dose used, but they can include fatigue, low blood cell counts, risk of infection, hair loss, nausea and vomiting, loss of appetite, and diarrhea. These side effects usually go away once treatment is finished. The severity of side effects may also be affected by other factors, including genetic differences in the way the drugs are used by the body and the child’s overall health and well-being. Doctors understand that everyone is different. Most children are initially treated similarly to other children with the same cancer. However, based on the side effects, doses or schedules may be changed. This is a constant balance between the effort to kill all the cancer cells and the need to avoid severe complications. Your child’s doctor will discuss changes to the treatment plan with you as they are needed, and not all children will need to have their chemotherapy changed. Learn more about chemotherapy and preparing for treatment. The medications used to treat cancer are continually being evaluated. Talking with the doctor is often the best way to learn about the medications prescribed for your child, their purpose, and their potential side effects or interactions with other medications. Learn more about your child’s prescriptions by using searchable drug databases. Stem cell transplantation/bone marrow transplantation Children with AML have different risks of recurrence depending on the subtype. For children with a higher risk of recurrence, it is more likely that the doctor will recommend stem cell transplantation to help prevent a recurrence. A stem cell transplant is a medical procedure in which diseased bone marrow is replaced by highly specialized cells, called hematopoietic stem cells. Hematopoietic stem cells are the cells that normally become bone marrow. They are found both in the bloodstream and in the bone marrow. Today, this procedure is more commonly called a stem cell transplant because it is the blood stem cells that are typically being transplanted, not the actual bone marrow tissue. Before recommending stem cell transplantation, doctors will talk with the patient about the risks of this treatment and consider several other factors, such as the type of leukemia, results of any previous treatment, and patient’s age and general health. Not all children with AML need stem cell transplantation. For instance, children with Down syndrome and the subtype called APL with t(15;17) do not need stem cell transplantation unless the AML recurs. AML with certain genetic changes (for example, chromosome abnormalities known as inv 16 and t[8;21], or molecular changes known as NPM1 or CEBPa) is not treated with stem cell transplantation unless the leukemia has recurred. Children with subtypes of AML that have lower risks of recurrence (and therefore higher chances of cure) can usually be treated with chemotherapy alone. There are two types of stem cell transplantation depending on the source of the replacement blood stem cells: allogeneic (ALLO) and autologous (AUTO). ALLO transplantation is the type most often used for AML. In an ALLO transplant, stem cells are obtained from a donor whose tissue most closely matches the patient’s on a genetic level; this testing is called HLA-typing. Most often, a patient’s brother or sister serves as the donor, although unrelated donors can serve as the donor too. Millions of people worldwide have volunteered to donate stem cells for patients who do not have matched family members; your health care team will search a computer registry to look for a match. In addition, a donation of stem cells derived from umbilical cord blood is sometimes considered if family donors are not available. For children with an average (also called intermediate) risk for recurrence and survival, when a related donor is available, stem cell transplantation is the preferred choice of treatment after a child has a first remission. For children with the highest risk of recurrence and the poorest chance of recovery, stem cell transplantation with either a related or unrelated donor is often used in addition to chemotherapy after the child has a first remission. In general, transplantations from unrelated donors are not done unless the AML has recurred. However, as the safety of using stem cells/bone marrow from unrelated donors has improved, these types of transplants are being used more often to prevent recurrence for children with high risk AML. Clinical trials are studying the use of unrelated donor transplants for patients with AML that has certain high-risk features (for example, a chromosome abnormality called monosomy 7 or a child who doesn’t experience a complete or partial remission after their first induction chemotherapy). The goal of stem cell transplantation is to destroy cancer cells in the marrow, blood, and other parts of the body and allow replacement blood stem cells to create healthy bone marrow. In most stem cell transplants, the patient is treated with high doses of chemotherapy and/or radiation therapy to destroy as many cancer cells as possible. This also destroys the patient’s bone marrow tissue and suppresses the patient’s immune system so that, in an ALLO transplant, the donor cells are not rejected by the body. After the high-dose treatment is given, blood stem cells are infused into the patient’s vein to replace the bone marrow and restore normal blood counts from donor cells. Sometimes, ALLO transplants can also be performed after giving lower doses of chemotherapy and/or radiation therapy that are still sufficient to suppress the immune system and allow growth of the donor cells. (These transplants, sometimes termed “mini-transplants” or reduced-intensity transplants, have less immediate side effects, allowing the procedure to be used for more fragile patients.) In an ALLO transplantation, the replacement cells engraft (begin to make new blood cells) and turn into healthy, blood-producing tissue in 10 days to three weeks. Destroying the patient’s own marrow reduces the body’s natural defenses, temporarily leaving the patient at an increased risk of infection. Until the patient’s immune system is back to normal, patients may need antibiotics and blood transfusions, and they need to follow certain safety restrictions provided by the health care team to help avoid infections. In an ALLO transplant, another major risk is that the donor’s cells will recognize the patient’s body as foreign, causing graft-versus-host disease (GVHD). GVHD may be a serious complication of allogeneic transplants and can be fatal. Other side effects may include liver problems, diarrhea, infections, and rashes. However, GVHD can also be a benefit because the donor cells can recognize the cancer cells as foreign and destroy these cells, a mechanism that is one of the major reasons why ALLO transplantation generally works so well over the long term. The risk of GVHD can be reduced with exact HLA-type matching and the use of preventive drugs. Learn more about bone marrow and stem cell transplantation. Radiation therapy Radiation therapy is the use of high-energy x-rays or other particles to kill cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist. The most common type of radiation treatment is called external-beam radiation therapy, which is radiation given from a machine outside the body. A radiation therapy regimen (schedule) usually consists of a specific number of treatments given over a set period of time. Radiation therapy for AML is generally used only if the cancer has spread to the brain and does not respond to systemic chemotherapy and/or chemotherapy given into the spinal fluid. Radiation therapy may also be used to treat a chloroma when chemotherapy has not fully worked. As explained above, radiation therapy may also be used during a stem cell/bone marrow transplant. Side effects from radiation therapy may include fatigue, mild skin reactions, upset stomach, and loose bowel movements. Most side effects go away soon after treatment is finished. Radiation therapy can sometimes interfere with the normal growth and development of the child’s brain and body. Therefore, when possible, chemotherapy is used first to avoid radiation therapy. More information about long-term effects can be found in the After Treatment section. Learn more about radiation therapy. Recurrent AML Once your child’s treatment is complete and there is a remission (absence of cancer symptoms; also called “no evidence of disease” or NED), talk with your child’s doctor about the possibility of the cancer returning. Many families feel worried or anxious that the cancer will come back. Learn more about coping with this fear. If the cancer does return after the original treatment, it is called recurrent cancer. Most often, AML comes back in the bone marrow, but sometimes it may come back in the brain or other parts of the body. When this occurs, a cycle of testing will begin again to learn as much as possible about the recurrence. After testing is done, you and your child’s doctor will talk about your treatment options. Treatment usually includes chemotherapy followed by stem cell transplantation. Each child’s treatment is planned based on their specific circumstances. Your doctor may also suggest clinical trials that are studying new ways to treat this type of recurrent cancer. For some children, recurrent AML can be cured. When cancer recurs, patients and their families often experience emotions such as disbelief or fear. Families are encouraged to talk with their health care team about these feelings and ask about support services to help them cope. Learn more about dealing with cancer recurrence. If treatment fails Although treatment is successful for the majority of children with cancer, sometimes it is not. If a child’s cancer cannot be cured or controlled, this is called advanced or terminal cancer. This diagnosis is stressful, and it may be difficult to discuss. However, it is important to have open and honest conversations with your child’s doctor and health care team to express your family’s feelings, preferences, and concerns. The health care team is there to help, and many team members have special skills, experience, and knowledge to support patients and their families. Parents or guardians are encouraged to think about where the child would be most comfortable: at home, in a home-like setting elsewhere, in the hospital, or in a hospice environment. Nursing care and special equipment can make staying at home a workable alternative for many families. Some children may be happier if they can arrange to attend school part-time or keep up other activities and social connections. The child’s health care team can help parents or guardians decide on an appropriate level of activity. Making sure a child is physically comfortable and free from pain is extremely important as part of end-of-life care. Learn more about caring for a terminally ill child and advanced cancer care planning. The death of a child is an enormous tragedy, and families may need support to help them cope with the loss. Pediatric cancer centers often have professional staff and support groups to help with the process of grieving. Learn more on grieving the loss of a child. Find out more about common terms used during cancer treatment. About Clinical Trials
Doctors and scientists are always looking for better ways to treat children with AML. To make scientific advances, doctors create research studies involving people, called clinical trials. Many clinical trials are focused on new treatments, evaluating whether a new treatment is safe, effective, and possibly better than the current (standard) treatment. These types of studies evaluate new drugs, different combinations of existing treatments, new approaches to radiation therapy or surgery, and new methods of treatment. Children who participate in clinical trials are often among the first to receive new treatments before they are widely available. However, there is no guarantee that the new treatment will be safe, effective, or better than a standard treatment. There are also clinical trials that study new ways to ease symptoms and side effects during treatment and manage the late effects that may occur after treatment. Talk with your doctor about clinical trials regarding side effects. In addition, there are ongoing studies about ways to prevent the disease. Patients decide to participate in clinical trials for many reasons. For some children, a clinical trial is the best treatment option available. Because standard treatments are not perfect, patients are often willing to face the added uncertainty of a clinical trial in the hope of a better result. Other patients volunteer for clinical trials because they know that these studies are the only way to make progress in treating AML. Even if they do not benefit directly from the clinical trial, their participation may benefit future people with AML. Sometimes people have concerns that, by participating in a clinical trial, they may receive no treatment by being given a placebo or a “sugar pill.” The use of placebos in cancer clinical trials is rare, and placebos are never used in clinical trials for the treatment of children with cancer. When a placebo is used in a study, it is done with the full knowledge of the participants. Find out more about placebos in cancer clinical trials. To join a clinical trial, parents and children must participate in a process known as informed consent. During informed consent, the doctor should list all of the patient’s options so that the person understands how the new treatment differs from the standard treatment. The doctor must also list all of the risks of the new treatment, which may or may not be different from the risks of standard treatment. Finally, the doctor must explain what will be required of each patient in order to participate in the clinical trial, including the number of doctor visits, tests, and the schedule of treatment. Learn more about clinical trials, including patient safety, phases of a clinical trial, deciding to participate in a clinical trial, questions to ask the research team, and links to find clinical trials. For specific topics being studied for childhood AML, learn more in the Current Research section. Patients who participate in a clinical trial may stop participating at any time for any personal or medical reason. This may include that the new treatment is not working or there are serious side effects. It is important that patients participating in a clinical trial talk with their doctor and researchers about who will be providing their treatment and care during the clinical trial, after the clinical trials ends, and/or if the patient chooses to leave the clinical trial before it ends. Side Effects
Cancer and its treatment can cause a variety of side effects. However, doctors have made major strides in recent years in reducing pain, nausea and vomiting, and other physical side effects of cancer treatments. Many treatments used today are less intensive but as effective as treatments used in the past. Doctors also have many ways to provide relief to patients when such side effects occur. Fear of treatment side effects is common after a diagnosis of cancer, but it may be helpful to know that preventing and controlling side effects is a major focus of your child’s health care team. Before treatment begins, talk with your child’s doctor about possible side effects of the specific treatments your child will be receiving. The specific side effects that can occur depend on a variety of factors, including the type of cancer, its location, the individual treatment plan (including the length and dosage of treatment), and your child’s overall health. Common side effects for each treatment option are described in detail within the Treatment section. Ask your doctor which side effects are most likely to happen (and which are not), when side effects are likely to occur, and how they will be addressed by the health care team. Also, be sure to communicate with your doctor about side effects your child experiences during and after treatment. Care of a patient’s symptoms and side effects is an important part of a person’s overall treatment plan; this is called palliative or supportive care. It helps people with cancer at any stage of illness be as comfortable as possible. Learn more about the most common side effects of cancer and different treatments, along with ways to prevent or control them. Be sure to talk with your doctor about the level of caregiving your child may need during treatment and recovery, as family members and friends often play an important role in the care of a person with AML. Learn more about caregiving. In addition to physical side effects, there may be psychosocial (emotional and social) effects as well. For many patients, a diagnosis of AML is stressful and can bring difficult emotions. Patients and their families are encouraged to share their feelings with a member of their health care team who can help with coping strategies. Learn more about the importance of addressing such needs, including managing the cost of cancer care. A side effect that occurs more than five years after treatment is called a late effect. Treatment of late effects is an important part of survivorship care. Learn more about late effects or long-term side effects by reading the After Treatment section or talking with your child’s doctor. After Treatment
After treatment for AML ends, talk with your child’s doctor about developing a follow-up care plan. This plan may include regular physical examinations and/or medical tests to monitor your child’s recovery for the coming months and years. All children treated for cancer, including AML, should have life-long, follow-up care. Based on the type of treatment the child received, the doctor will plan what examinations and tests are needed to check for long-term side effects, such as problems with the heart, lungs, or growth hormones, the development of a learning disability, and the possibility of secondary cancers. While this risk is generally low, your child should be closely monitored for their entire life for secondary cancers. Your child’s doctor can recommend the necessary screening tests. Follow-up care should also address the child’s quality of life, including any developmental or emotional concerns. Learn more about childhood cancer survivorship. The child’s family is encouraged to organize and keep a record of the child’s medical information so that, as the child enters adulthood, he or she has a clear, written history of the diagnosis, the treatment given, and the doctor’s recommendations about the schedule for follow-up care. The doctor’s office can help you compile this. This information will be valuable to doctors who care for your child during his or her lifetime. ASCO offers cancer treatment summary forms to help keep track of the cancer treatment your child received and develop a survivorship care plan once treatment is completed. Children who have had cancer can also enhance the quality of their future by following established guidelines for good health into and through adulthood, including not smoking, maintaining a healthy weight, eating a balanced diet, and participating in regular physical activity. Talk with the doctor about developing a plan that is best for your child’s needs. Learn more about the next steps to take in survivorship. Find out more about common terms used after cancer treatment is complete. Current Research
Doctors are working to learn more about AML, ways to prevent it, how to best treat it, and how to provide the best care to people diagnosed with this disease. The following areas of research may include new options for patients through clinical trials. Always talk with your child’s doctor about the diagnostic and treatment options best for your child. Genetic testing. The genetics of leukemia cells are being tested to see if they can help doctors decide which patients may need more or less intense treatment. These discoveries help doctors better understand the causes of leukemia, establish a prognosis for each child, and develop new drugs that target these specific genetic mutations. Better detection. New methods to measure minimal residual disease can find one leukemia cell in 10,000 normal cells, which can help determine the likelihood of recurrence. In the future, changes made to chemotherapy treatments and/or the use of stem cell transplantation may be partly based on these new types of tests. New drugs and combinations of drugs. Targeted therapy is a treatment that targets the cancer’s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. This type of treatment blocks the growth and spread of cancer cells while limiting damage to normal cells, usually leading to fewer side effects than other cancer medications. Sorafenib (Nexavar) is a type of targeted therapy called a protein kinase inhibitor that specifically targets AML blasts with the Flt3 mutation. It is being tested in combination with chemotherapy for children newly diagnosed with AML. Other new drugs that may be used for AML are being tested in clinical trials or are in development in research laboratories around the world. Learn more about targeted treatments. Supportive care. Clinical trials are underway to find better ways of reducing symptoms and side effects of current leukemia treatments in order to improve patients’ comfort and quality of life. Learn more about common statistical terms used in cancer research. Looking for More about Current Research? If you would like additional information about the latest areas of childhood leukemia research, explore these related items:
Or, choose “Next” (below, right) to continue reading this detailed section. Questions to Ask the Doctor
Talking often with the doctor is important to make informed decisions about your child’s health care. These suggested questions are a starting point to help you learn more about your cancer care and treatment. You are also encouraged to ask additional questions that are important to you.
Patient Information Resources
In addition to Cancer.Net, there are other sources of information about this type of cancer available online. Cancer.Net maintains a list of national, not-for-profit organizations that may be helpful in finding additional information, services, and support. As always, be sure to talk with your doctor about questions you may have about information you find about this disease. View organizations that offer information on this specific type of cancer. |
