Acute Myeloid Leukemia

On your child’s first visit, we’ll start with a physical exam. We’ll look for areas of bleeding or bruising and enlarged lymph nodes. All of these are common AML symptoms.

We’ll also do other diagnostic tests. Based on the results of these tests, we’ll assign what is called a subtype to your child’s cancer. The subtype can help us to figure out their personalized treatment plan for potentially good outcomes. Other tests may include:

Bone marrow aspiration

We might run a test called a bone marrow aspiration. This test lets us check tissue samples to see if your child’s body is making healthy blood cells in their bones and bone marrow. Marrow is the spongy tissue inside of bones that produces blood cells. We’ll do this by removing a small piece of bone and some liquid marrow from your child’s hip or breastbone. Don’t worry, we’ll numb the area first. Depending on your child, we might even give them a sedative before we take a sample. They’ll be able to go home after the test. They’ll wear a small bandage and might be sore for a couple of days.

Spinal tap

Your child could also have a spinal tap (lumbar puncture) so we can test their spinal fluid for cancer cells. We’ll remove a fluid sample from around your child’s spinal cord through their lower back. We’ll use a needle and syringe to do this. Your child will have a local anesthetic, which could sting for a second or two. During the procedure, they might feel some pressure. But it won’t hurt. After the test, your child will need to remain lying down for an hour. After that, they can usually go home. They’ll need to get plenty of rest and fluids for a couple of days. Sometimes, they might get a headache for a day or two after the procedure.

Imaging

Our providers will also do imaging tests to take detailed pictures inside your child’s body. Looking at these pictures helps us rule out other health issues. These images also help your child’s care team see whether cancer has spread to any other parts of your child’s body. These tests can include a CT scan, MRI, ultrasound and X-rays.

Second opinions

Learning that your child may have cancer can be an emotional moment. You’ll want to make sure you’re working with a team of healthcare providers you trust to give your child the best possible treatment. At Cleveland Clinic Children’s, we encourage second opinions, and we try to provide priority appointments for anyone looking for one. When you come in for your appointment, we’ll ask you to bring all of your child’s medical records. Our team of experts will dive in to help you through the process of finding the best personalized treatment plan for your child. 

We develop a personalized care plan based on a variety of things — like the type of AML your child has, their age and their white blood cell count. AML treatment usually includes chemotherapy, but also includes other therapies to give your child the best possible results.

Chemotherapy

Chemotherapy means we give your child drugs through their vein with an IV tube. These drugs are made to destroy abnormal cells. Acute myeloid leukemia treatment involves two phases of chemotherapy — induction and consolidation therapies. Induction therapy helps get your child’s blood cell and bone marrow counts back to normal. Many patients will go into remission after this. 

Once we finish induction therapy, we’ll do consolidation therapy. This helps us destroy any remaining AML cells. Depending on their cancer, they’ll either get more chemotherapy or a stem cell transplant. In this treatment, we’ll infuse your child’s blood with new, healthy bone marrow cells provided by a matching donor. It’s also known as a bone marrow transplant.

Refractory or recurrent AML treatment

In a small percentage of children — less than 15% — acute myeloid leukemia doesn’t go into remission (refractory AML) or comes back after treatment (recurrent AML). If this happens, we’ll recommend further treatments like:

• Chemotherapy.
• Stem cell transplant. 
• Targeted therapy.

Routine monitoring

After your child finishes treatment, we’ll check on them often. This helps us find and treat any changes in your child’s health right away. These checkups will include regular blood and bone marrow tests for at least two years. After that time, it’s more unlikely that AML will return. The five-year survival rate for children with AML ranges from 65% to 70%.

Taking the Next Step

Cancer is hard. It’s even harder when your child is the one going through treatment. That’s why we’re here to help them (and your family) get the best diagnosis, treatment and ongoing care possible. Cleveland Clinic Children’s is the trusted coach your family needs to tackle this cancer journey. And your child is our star player. We’re here to help them play and enjoy life again.