You may be offered:

Chemotherapy
Chemotherapy uses special drugs to kill cancer cells. It is the main type of treatment for AML.

Your doctors will take several factors into account when planning your chemotherapy, including the exact type of leukaemia you have, and your age.

Most patients get their drugs as a series of injections. The injections are given over a 10-day period (a course), repeated every six weeks. The number of courses you need will depend on your response to the treatment.

To make the treatment easier and more comfortable for you, your nurse or doctor may put a thin plastic tube (a Hickman line) into a vein in your chest. Another method is to use a PICC line, which is fed through a vein in the arm and into a large vein in the chest. You have a local anaesthetic before the doctor or nurse puts the line in. Once it is in place, it stays there throughout your treatment. Each time you go for your chemotherapy your nurse injects the drugs painlessly through the line. S/he can also use the line to take samples of blood.

A few patients are able to take their chemotherapy drugs as tablets, but this is not very common. It depends which type of leukaemia you have.

The aim of chemotherapy is to kill all the leukaemia cells, so that your normal bone marrow can start to grow again. If this happens, the doctor will say that you are in remission. If there are no signs of active disease, this is called complete remission. If there is an improvement but the cancer is still there, this is a partial remission.

Many AML patients are treated with chemotherapy alone. Blood tests can tell your doctor whether this treatment stands a good chance of success.

If the doctor thinks the chances of success are less good, s/he may recommend one of the following treatments:

High dose chemotherapy with stem cell rescue
Some chemotherapy patients will be offered high dose chemotherapy with stem cell rescue, as part of a clinical trial.

Chemotherapy can damage bone marrow and lead to problems such as anaemia, infections and bleeding.

After standard chemotherapy, bone marrow recovers on its own, but high dose chemotherapy does more damage, and bone marrow needs help to recover.

Before you have high dose chemotherapy your doctors will take some stem cells from you. These are stored, ready to give back to you afterwards. When they are put back into your body the cells start to grow and multiply again.

There are two ways of getting the stem cells. The most usual way is to get them from the blood. A special machine collects bone marrow cells that are circulating in the blood. This is called peripheral blood stem cell harvesting. Less usually, some bone marrow is removed. This is called bone marrow harvesting.

After harvesting, you have your high dose of chemotherapy. Later your undamaged blood stem cells (or bone marrow) are given back to you through a drip.

The chemotherapy and stem cell rescue will involve a stay in hospital of two or three weeks.

Allogenic (donor) bone marrow transplant
In some cases the doctor may recommend an allogenic bone marrow transplant, usually after chemotherapy. This means taking healthy bone marrow cells from another person (a donor) and giving them to the patient.

The cells are normally taken from a close relative such as a brother or sister whose bone marrow is very like the patient's. If there is no close relative, doctors may be able to find another donor from a bone marrow register. The transplant can go ahead only if the donor is a close match.

Remember that your doctor will make a treatment plan especially for you. Some AML patients can be treated and cured by chemotherapy alone. Stem cell rescue and bone marrow transplants aren't suitable for all patients. Only your doctor can tell you what might be the best option for you. Cure tends to be more likely in younger patients.

If your AML doesn't respond to treatment, or if it comes back later, your doctor will need to talk with you about other treatment options. For example s/he may suggest trying different chemotherapy drugs. Some patients may be offered a bone marrow transplant at that time.

Secondary AML
If you have secondary AML, the disease is more difficult to treat. Secondary AML may occur in patients who have been treated for another cancer in the past, or who have had certain other conditions such as myelofibrosis. If you have secondary AML your doctor will tell you more about this and explain the treatment options to you.

Giving your consent
Your doctors will tell you about the risks, benefits and side-effects of your treatment options. You will need to agree to the treatment before it can start. This is called giving your consent. Don't be afraid to ask questions if there is anything you don't understand.