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Treatment and the treatment process

Treatment of AML

Acute myeloid leukemia (AML) develops quickly, and treatment usually starts without delay. This topic explains the main phases of AML treatment, the methods used and how the plan is chosen.

Last updated: ~3 min read
A path of light across a dark navy landscape, split into three coloured segments, leading to a calm sunrise.
Figure 1.AML treatment moves forward in phases.

01Short answer

AML treatment usually has two main phases. Induction aims for remission: in people who can tolerate intensive treatment, the “7+3” regimen (seven days of cytarabine and three days of an anthracycline) is often used, and a targeted drug (such as an FLT3 inhibitor) may be added based on genetics. Consolidation strengthens the remission with courses of high-dose cytarabine or, if the risk is high, an allogeneic stem cell transplant. For people who cannot have intensive treatment, gentler regimens are used, such as a hypomethylating drug with venetoclax. APL, a special type of AML, is treated quite differently. Throughout treatment, supportive care such as transfusions and preventing and treating infections is essential.

02Simple explanation

Induction. The first intensive course aims to reduce leukemia cells in the marrow as much as possible. Healthy blood cells also fall temporarily, so a few weeks in hospital are needed.

Checking for remission. After the course, the marrow is tested again. If blasts are below 5% and blood counts have recovered, this is called complete remission.

Consolidation. Further courses or a transplant to destroy hidden remaining cells.

Follow-up. Regular blood tests and doctor visits after treatment.

03Scientific explanation

Intensive treatment: according to the NCI and ACS, standard induction for people fit for intensive treatment combines cytarabine with an anthracycline (daunorubicin or idarubicin). An FLT3 inhibitor may be added for FLT3 mutations, and gemtuzumab ozogamicin in some CD33-positive AML with favourable genetics.

Consolidation: with favourable risk, courses of high-dose cytarabine are usually enough. With intermediate or adverse risk, an allogeneic transplant in first remission is considered if a suitable donor is available (ESMO, ELN).

Less intensive treatment: for older people or those with serious other illnesses, azacitidine or decitabine with venetoclax, or low-dose cytarabine, are used, often as outpatient treatment. Targeted drugs may be used for IDH1/IDH2 mutations.

04What happens in the body?

How is the plan chosen?

Doctors consider the AML genetics (risk group and targets), age, heart, kidney and liver function, general health and your wishes. Many centres agree the plan in a team discussion.

A translucent leukemia cell on a dark background with a glowing key entering a lock-shaped receptor on its surface.
Figure 3.Targeted drugs act on a specific genetic change.

What to expect during induction

The course usually lasts 7–10 days, followed by 2–4 weeks of very low blood counts. During this time, blood and platelets are transfused, infection prevention is given and antibiotics start quickly if fever occurs. Sometimes a second induction course is needed.

Bone marrow under a microscope: dense uniform blasts on the left, varied normal cells on the right.
Figure 2.The goal of induction: from a marrow full of blasts to a healthy one.

About transplant

A transplant is a powerful but risky treatment. Not everyone needs one: with favourable genetics, chemotherapy is often enough. The decision depends on the risk group, residual disease (MRD), donor availability and general health.

05The AML treatment path

A simplified general outline.

Induction — Reach remission.1InductionReach remission.
Check — Bone marrow and MRD.2CheckBone marrow and MRD.
Consolidation — Chemotherapy or transplant.3ConsolidationChemotherapy or transplant.
Follow-up — Regular tests.4Follow-upRegular tests.
RemissionNo visible leukemia.
TargetDrugs matched to genetics.
TeamA personal plan.

06Main approaches to treating AML

ApproachFor whom?Example
Intensive inductionPeople fit for intensive treatment“7+3”: cytarabine + anthracycline
Targeted add-onWhen a matching mutation is presentFLT3, IDH inhibitors
Consolidation chemotherapyFavourable and some intermediate riskHigh-dose cytarabine
Allogeneic transplantHigh risk, suitable donorIn first remission
Less intensive regimenOlder age or frailtyAzacitidine + venetoclax
APL treatmentAPLATRA + arsenic trioxide

* Simplified outline; your doctor chooses the specific drugs.

07Key terms

Induction
The first treatment phase, aiming for remission.
Consolidation
The phase that strengthens remission.
Complete remission
Marrow blasts below 5% with recovered blood counts.
MRD
Measurable residual disease.
Allogeneic transplant
A stem cell transplant from a donor.
Hypomethylating drug
A gentler drug that affects how a cell’s genes work (azacitidine, decitabine).

08Key points

  • AML treatment starts quickly.
  • Induction aims for remission.
  • Consolidation helps prevent return.
  • Genetics shapes the plan and targeted drugs.
  • Not everyone needs a transplant.
  • Supportive care is part of treatment.

09Frequently asked questions

How long is the hospital stay for induction?

Often 3–5 weeks, until blood counts recover.

What if remission is not reached?

Doctors may offer a second course or different drugs, including clinical trials.

Can older people be treated for AML?

Yes; gentler regimens suit many people. Age alone does not decide.

Can I work during treatment?

Usually not during intensive phases; some people keep working on gentler regimens.

10Questions for your doctor

Take these questions to your appointment. The ones you save are collected on the “My questions” page and stay on this device only.

  1. How long is the hospital stay for induction?

  2. What if remission is not reached?

  3. Can older people be treated for AML?

  4. Can I work during treatment?

My questions

12Sources

  1. National Cancer Institute (NCI). Adult Acute Myeloid Leukemia Treatment (PDQ) – Patient Version
  2. American Cancer Society. Typical Treatment of Acute Myeloid Leukemia (Except APL)
  3. NHS. Acute myeloid leukaemia: Treatment
  4. Cancer Research UK. Treatment for acute myeloid leukaemia (AML)
  5. Leukemia & Lymphoma Society. AML treatment
  6. ESMO. ESMO Clinical Practice Guidelines: Haematological Malignancies
  7. American Cancer Society. Living as an Acute Lymphocytic Leukemia Survivor
  8. American Cancer Society. ASCO Cancer Treatment and Survivorship Care Plans
  9. National Cancer Institute (NCI). Definition of relapse – NCI Dictionary of Cancer Terms
  10. National Cancer Institute (NCI). Types of Cancer Treatment
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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