Remission Induction
There are two different forms of chemotherapy given to patients who have been diagnosed with AML (acute myeloid leukemia). The first form is called remission induction, which is designed to destroy all detectable cancer cells; the second is called "consolidation therapy," which works to prevent relapses. Remission induction chemotherapy typically involves the administration of two different medications: cytarabine and daunorubicin, both of which work to cause damage to DNA as it is being replicated. Sometimes remission induction therapy involves an additional drug, called 6-thioguanine, which also damages DNA. AML cells divide more quickly than normal cells, which means they make more DNA than normal cells as well. As a result, drugs that cause DNA damage affect the cancer cells more than other tissues and can kill the cancer cells.
Consolidation Therapy
After a patient has been successfully put into remission using the above chemotherapy regimen, doctors often recommend a second course of chemotherapy, called consolidation therapy. This treatment works to destroy any cancer cells that remain and to prevent relapses. Consolidation therapy typically uses only Cytarabine at high doses as its chemotherapeutic agent. Another option for consolidation therapy is to completely destroy the patient's bone marrow (using chemotherapy) and then replacing the bone marrow with a bone marrow transplant.
APL Treatment
One variant of AML is also known as Acute Promyelocytic Leukemia (APL). Although it is a subtype of AML, it requires a different treatment regimen. Patients with APL have a high risk of developing blood clotting problems, and so they need to be treated differently. In general, patients with APL are given daunorubicin (which causes DNA damage in cancer cells) and another medication called all-trans retinoic acid (which is chemically similar to vitamin A). The daunorubicin kills the cancer cells and the retinoic acid also helps poison cancerous cells. This type of treatment rapidly causes remission in patients with APL.
