A child's cancer diagnosis can bring with it feelings of uncertainty for parents and other family members. Suddenly, you're thrust into a fast-paced world of change, worry, fear and concern. You'll need to make treatment decisions while taking the time to comfort your child - and at the same time trying to cope with your own emotions.
Acute myeloid leukemia (AML) in children is one of the most challenging cancers to treat. Your child could face a long treatment period. Many children with AML are treated in clinical trials.
Generally, AML treatment is less effective for children who:
- are younger than 2 years old
- have the AML subtype acute monocytic leukemia
- have a type of leukemia called hyperleukocytic leukemia, which has a high number of blast cells
When it comes to finding the right treatment for your child's cancer, a clinical trial may be your best bet. Your child will have access to new or improved therapies under study and not yet on the market. Discuss with your child's doctor the possibility of participating in a clinical trial, where treatment is administered in a safe, closely monitored environment.
Researchers are studying treatment for children and younger adults with AML in clinical trials with the aim to:
- improve cure rates
- decrease long-term and late effects of chemotherapy
- make AML therapy safer and reduce chemotherapy's side effects and complications like infections
- determine the best treatments for children who have a poor chance of recovering from AML
Researchers have also identified targets on cells that appear to be the key to treating AML with the new generation of chemotherapy drugs. Scientists are looking at these new targeted agents to determine their impact on cure rates and toxic effects on the body associated with traditional chemotherapy. Although chemotherapy has been used in different combinations and doses over the past several decades, leading to improved childhood AML cure rates, some young patients have a low-tolerance level.
Chemotherapy is successful in bringing about a remission (no signs or symptoms of the disease) in 80 percent of children with AML. After five years, nearly half of all children treated for AML experienced remission. Slightly more than half the children in relapse-free remission are considered cured. Children under age 2 have a lower chance of remission and cure than do older children.
Children with AML are treated in much the same way as adults with AML are treated. Chemotherapy is the first line of defense beginning with induction therapy. The chemotherapy drug cytarabine (Cytosar-U®, cytosine arabinoside, ara-C) is combined with a type of drug called an anthracycline, such as doxorubicin (Adriamycin®PFS, Adriamycin®) or daunomycin. A third drug called mitoxantrone (Novantrone®) is sometimes used as well. Infants are usually treated with the same therapy.
Stem Cell Transplantation
Your child's doctor may suggest a stem cell transplantation in addition to chemotherapy. An allogeneic stem cell transplantation, when cells are taken from a healthy donor, is used to treat children who:
- have a poor chance of recovery based on chromosome and molecular test results
- don't respond well to induction therapy
- relapse after intensive postremission therapy
Survivorship and Special Healthcare Needs
After treatment, most children can expect to have full and productive lives. Many survivors return to school, attend college, enter the workforce, marry and become parents.
Childhood cancer survivors have special long-term healthcare needs. You may want to consider a survivorship program for your child that focuses on life after cancer. Several major hospitals around the country offer these programs.
More to Explore
- Understanding your child's ongoing healthcare needs
- Survivorship resources for children and families
- Download or order The Leukemia & Lymphoma Society's (LLS's) free fact sheet Choosing a Blood Cancer Specialist or Treatment Center
- Download or order LLS's free booklet Knowing All Your Treatment Options
- Download questions to ask your doctor about treatment options