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
Acute myeloid leukemia (AML) is one of the most challenging childhood cancers to treat. Because of the intensity of therapy utilized to treat AML, children with this disease should have their care coordinated by pediatric hematology-oncology specialists and be treated in cancer centers or hospitals with the appropriate supportive care facilities and services.
Chemotherapy. Children who have AML are treated with an induction therapy similar to that for adults with AML: cytarabine and drugs such as doxorubicin or daunorubicin, or a third drug, such as mitoxantrone. More treatment is needed after a child with AML is in remission (postremission therapy). This is because some AML cells may remain after induction therapy and these AML cells do not show up in standard blood or marrow tests. Postremission therapy in children includes a number of chemotherapy drugs. This treatment results in about an 80 percent remission rate. Slightly more than half of the children in relapse-free remission are considered cured.
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
For children who receive intensive chemotherapy, including anthracyclines, ongoing monitoring of cardiac function is critical since these drugs may affect the heart. Periodic examination of kidney function and auditory exams are also recommended.
Clinical Trials. 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 side effects and 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 identified cell targets that appear to be the key to treatment with the new generation of chemotherapy agents. These new targeted agents are being studied in conjunction with chemotherapy to examine their impact upon cure rates and their effect on toxic complications associated with traditional chemotherapy.
Stem Cell Transplantation. An allogeneic stem cell transplantation may be used to treat children who have
- High-risk AML, based on cytogenetic and molecular test results
- Primary induction failure
- Relapse after intensive multidrug 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. For children who receive intensive chemotherapy, including anthracyclines, ongoing monitoring of cardiac function is critical since these drugs may affect the heart. Periodic examination of kidney function and auditory exams are also recommended.
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.
Physical Effects. Children treated for acute myeloid leukemia may be at increased risk for:
- Growth delays
- Thyroid dysfunction
- Hearing loss
- A secondary cancer
Mental Effects. 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.
Cognitive Effects. 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.
- 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