To access information about coping with childhood cancer, click here.
Click here for childhood AML statistics.
Click on the links below for more information about childhood AML:
- Survivorship and Special Healthcare Needs
- Follow-Up Care
- Long-Term and Late Effects of Treatment
- Returning to School
- Ongoing Research
Acute myeloid leukemia (AML) in children is one of the most challenging cancers to treat. Children with AML 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 a child's AML, a clinical trial may be the best treatment option, as clinical trials provide access to new or improved therapies under study and not yet on the market. Treatment in clinical trials is administered in a safe, closely monitored environment. The possibility of participating in a clinical trial should be discussed with the doctor.
Researchers are studying treatment in clinical trials for children and young adults with AML with the aim to:
- Improve cure rates
- Decrease long-term and late effects of chemotherapy
- Make AML therapy safer and reduce chemotherapy side effects and complications, such as 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 targeted chemotherapy drugs. Scientists are looking at these new targeted drugs 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 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. This treatment is followed by a complex multi-drug program. Infants are usually treated with the same therapy.
Stem Cell Transplantation
A 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
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. Survivorship programs focus on life after cancer and can be very helpful for children with cancer. Several major hospitals around the country offer these programs.
A child should visit his or her pediatrician or doctor at least once a year for a complete physical exam and any additional needed tests. The oncologist should also regularly examine the child.
Regular doctor visits are encouraged to:
- Enable doctors to assess the full effect of therapy
- Detect and treat disease recurrence
- Identify and manage long-term and late effects of treatment
The pediatrician should recommend a schedule for having the child's learning skills assessed. If the child appears to be experiencing learning disabilities, special education methods can help.
Coordination between the child's pediatrician and oncologist is important for the best care possible. Some treatment centers offer comprehensive follow-up care clinics for childhood cancer survivors. To find one near you, visit The Pediatric Oncology Resource Center.
Some side effects of cancer treatment, such as fatigue, can linger for months or years after therapy. Some medical conditions like heart disease and other cancers may not appear until years after treatment ends.
Most childhood survivors of leukemia don't develop significant long-term or late effects of treatment. However, for some patients the effects can range from mild to severe.
Talk to the child's treatment team about possible long-term and late effects. His or her risk for developing long-term or late effects can be influenced by:
- Treatment type and duration
- Age at the time of treatment
- Overall health
Some long-term and late effects become evident with maturation (puberty), growth and the normal aging process. Have the child evaluated with a physical exam yearly or more often as needed. Early intervention and healthy lifestyle practices (not smoking, good nutrition, exercise, regular screenings and follow-up) help.
Long-term and late effects can impact a child's physical, mental and cognitive health in a number of ways.
Children treated for acute myeloid leukemia may be at increased risk for:
- Growth delays
- Thyroid dysfunction
- Hearing loss
- A secondary cancer
Most childhood survivors of cancer are psychologically healthy. However, some studies have indicated that a small number of childhood leukemia survivors were more likely than healthy peers to report changes in mood, feelings and behavior, including depression and posttraumatic stress disorder.
Learning disabilities can begin during treatment or appear months or years afterward. Areas that can be affected include:
- Spatial relationships
- Problem solving
- Attention span
- Information processing
- Planning and organizing
- Concentration skills
- Fine motor coordination
Once your child is in remission, he or she will likely be going back to school. This reentry to the classroom can be daunting for a child of any age. Educate family members, friends, school personnel and healthcare providers about your child's possible long-term and late effects of treatment. Talk with teachers about your child's needs before he or she returns to school. Work with your child's teachers and medical providers to develop a program tailored to his or her needs that features baseline testing, special accommodations and long-term planning.
Click here to read about children with cancer returning to school.
Researchers are working to improve their understanding of long-term and late effects and to create guidelines for follow-up care. They're also seeking to understand how factors like aging and social and economic status influence long-term and late effects.
- Download lists of suggested questions to ask your healthcare providers about treatment options
- Download or order LLS's free booklets:
- Learning and Living with Cancer: Advocating for Your Child's Educational Needs
- Long Term and Late Effects of Treatment for Childhood Leukemia or Lymphoma Facts
- Choosing a Blood Cancer Specialist or Treatment Center
- Knowing All Your Treatment Options
- About Childhood Blood Cancer
- Long-Term And Late Effects Of Treatment For Childhood Cancer Survivors
- Follow-Up Care for Childhood Cancer Survivors