All FAB subtypes except M3 are usually given induction chemotherapy with cytarabine (ara-C) and an anthracycline (such as daunorubicin or idarubicin).[32] This induction chemotherapy regimen is known as "7+3" (or "3+7"), because the cytarabine is given as a continuous IV infusion for seven consecutive days while the anthracycline is given for three consecutive days as an IV push. Up to 70% of patients will achieve a remission with this protocol.[33] Other alternative induction regimens, including high-dose cytarabine alone or investigational agents, may also be used.[34][35] Because of the toxic effects of therapy, including myelosuppression and an increased risk of infection, induction chemotherapy may not be offered to the very elderly, and the options may include less intense chemotherapy or palliative care.
The M3 subtype of AML, also known as acute promyelocytic leukemia, is almost universally treated with the drug ATRA (all-trans-retinoic acid) in addition to induction chemotherapy.[36][37][38] Care must be taken to prevent disseminated intravascular coagulation (DIC), complicating the treatment of APL when the promyelocytes release the contents of their granules into the peripheral circulation. APL is eminently curable with well-documented treatment protocols.
The goal of the induction phase is to reach a complete remission. Complete remission does not mean that the disease has been cured; rather, it signifies that no disease can be detected with available diagnostic methods.[32] Complete remission is obtained in about 50%–75% of newly diagnosed adults, although this may vary based on the prognostic factors described above.[39] The length of remission depends on the prognostic features of the original leukemia. In general, all remissions will fail without additionalconsolidation therapy.[40]
Consolidation
Even after complete remission is achieved, leukemic cells likely remain in numbers too small to be detected with current diagnostic techniques. If no further postremission or consolidation therapy is given, almost all patients will eventually relapse.[41] Therefore, more therapy is necessary to eliminate non-detectable disease and prevent relapse — that is, to achieve a cure.
The specific type of postremission therapy is individualized based on a patient's prognostic factors (see above) and general health. For good-prognosis leukemias (i.e. inv(16), t(8;21), and t(15;17)), patients will typically undergo an additional 3–5 courses of intensive chemotherapy, known as consolidation chemotherapy.[42][43] For patients at high risk of relapse (e.g. those with high-risk cytogenetics, underlying MDS, or therapy-related AML), allogeneic stem cell transplantation is usually recommended if the patient is able to tolerate a transplant and has a suitable donor. The best postremission therapy for intermediate-risk AML (normal cytogenetics or cytogenetic changes not falling into good-risk or high-risk groups) is less clear and depends on the specific situation, including the age and overall health of the patient, the patient's personal values, and whether a suitablestem cell donor is available.[43]
For patients who are not eligible for a stem cell transplant, immunotherapy with a combination of histamine dihydrochloride (Ceplene) and interleukin-2 (Proleukin) after the completion of consolidation has been shown to reduce the absolute relapse risk by 14%, translating to a 50% increase in the likelihood of maintained remission.[44]
Relapsed AML
For patients with relapsed AML, the only proven potentially curative therapy is a hematopoietic stem cell transplant, if one has not already been performed.[45][46][47] In 2000, the monoclonal antibody-linked cytotoxic agent gemtuzumab ozogamicin (Mylotarg) was approved in the United States for patients aged more than 60 years with relapsed AML who are not candidates for high-dose chemotherapy.[48]
Patients with relapsed AML who are not candidates for stem cell transplantion, or who have relapsed after a stem cell transplant, may be offered treatment in a clinical trial, as conventional treatment options are limited. Agents under investigation include cytotoxic drugs such as clofarabine as well as targeted therapies such as farnesyl transferase inhibitors, decitabine, and inhibitors of MDR1 (multidrug-resistance protein). Since treatment options for relapsed AML are so limited, another option which may be offered ispalliative care.
For relapsed acute promyelocytic leukemia (APL), arsenic trioxide has been tested in trials and approved by the Food and Drug Administration. Like ATRA, arsenic trioxide does not work with other subtypes of AML.[49]
(reference: wikipedia.com)
It's a good thing my eldest sister was able to convince him to undergo treatment because it definitely helped. After my father agreed to have Chemotherapy, we immediately arranged for living arrangements as well as hospital accommodations (since it would be too much of a hassle and discomfort to have to travel back and forth between two cities while he was undergoing treatment).
When he was already in Chemotherapy, he would stay at the hospital for days to a week. The amount of medications he had to take and the strength of each one of those medicines took a toll on his body. Sometimes he would have hallucinations and would bruise all over. He became very thin, his hairs started to fall off (which was why he decided to shave his head off). He was very prone to infections and was always feverish. From time to time he would need blood transfusions.
Through all these, despite the emotional, mental and physical torture that my father went through, he still managed to survive and be in good health again. He has been cancer-free for almost five years and is as strong as can be at 69 years old. I and my family, including my father, have always been and will always be grateful to God for my father's second chance at life.
In serious medical conditions as my father once had, a strong support system is truly a really big morale booster. It helps keep the patient's hopes up and keeps him fighting for his life. I believe that is what happened with my father. Aside from the fact that he is a strong person (emotionally and physically), his unwavering faith in God and his family never leaving his side strengthened his resolve to overcome his sickness and continue living.