About chemotherapy for acute myeloid leukaemia

Chemotherapy uses anti-cancer or ‘cytotoxic’ drugs to destroy cancer cells. They work by disrupting the growth of cancer cells. As they circulate in the blood, they can reach cancer cells wherever they are in your body.

You usually have chemotherapy directly into your bloodstream for leukaemia. Some chemotherapy drugs are tablets or capsules that you swallow. To give chemo directly into the blood, you have a central line put in. This thin plastic tube goes into your chest and into one of the largest veins in your body. It can be attached to a tube with a bag of fluid (a drip). Or to a syringe, to give drug injections or take blood samples. Older patients having 'maintenace' treatment sometimes have cytarabine chemotherapy as a little injection just under the skin. 

You have the tube put into your chest under local or general anaesthetic. The last 6 inches or so of the tube hangs out of your chest. The tube has a clamp and a cap to keep it sealed when it is not in use.

The tube stays in for as long as you need it. A nurse will show you how to look after it and keep it clean.

Instead of a central line, you may have another type of line called a portacath. You have a small chamber put under the skin of your chest, under local anaesthetic. The chamber is attached to a tube inside the chest, which feeds into a large vein. To give your chemotherapy, your doctor or nurse pushes a fine needle through your skin into the chamber.

Most people who have chemotherapy for acute myeloid leukaemia have to stay in hospital. This is because

• It is demanding treatment
• You will have side effects that the hospital staff can help control
• You may need antibiotics into a vein to treat infection

Your treatment is in two phases

• Getting rid of the AML (induction)
• Treatment to stop AML coming back (consolidation)

Getting rid of the AML (induction)

Your first treatment aims to get your leukaemia into remission. Remission means there are no leukaemia cells in your blood or bone marrow. This phase of treatment is called 'induction therapy' or ‘remission induction’.

You have several different chemotherapy drugs in cycles of treatment. You have treatment for a few days, then a rest period. After the rest period, you may have more treatment, and so on. The treatment causes side effects. You can find out about chemotherapy drugs for AML and their side effects in this section of CancerHelp UK. Your doctors and nurses will give you treatments to reduce side effects. For example, you will be likely to get infections or have bleeding. So you will need to have antibiotics and blood transfusions. You may need to stay in hospital for about a month while you have this treatment and then recover from it.

Treatment to stop AML coming back (consolidation)

The second phase of AML treatment is called ‘consolidation treatment’. You have this when your leukaemia has gone into remission. There are different types of consolidation treatment. You may have high doses of one of the chemotherapy drugs that you had as part of your induction treatment. Or you may have intensive treatment, with a bone marrow or stem cell transplant.

For more information about chemotherapy, look at the main chemotherapy section in CancerHelp UK. It explains the treatment in detail including

• How chemo works
• How doctors plan chemotherapy
• How you have chemotherapy
• General chemo side effects
• Living with chemotherapy