Newly Diagnosed Childhood Acute Myeloid Leukemia
Childhood Acute Myeloid Leukemia in Remission
Recurrent Childhood Acute Myeloid Leukemia
Acute Promyelocytic Leukemia
Children with Down Syndrome and AML
Childhood Chronic Myelogenous Leukemia
Juvenile Myelomonocytic Leukemia
Transient Myeloproliferative Disorder
Myelodysplastic Syndromes

A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.

Treatment of newly diagnosed childhood acute myeloid leukemia (AML) is combination chemotherapy. CNS sanctuary therapy is intrathecal chemotherapy with or without radiation therapy to the brain.

Treatment of newly diagnosed childhood acute leukemia with a granulocytic sarcoma (chloroma) may include chemotherapy with or without radiation therapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with untreated childhood acute myeloid leukemia and other myeloid malignancies ¹.

Treatment of childhood acute myeloid leukemia (AML) during the remission phase (consolidation /intensification therapy) depends on the subtype of AML and may include the following:

• Combination chemotherapy.
• Stem cell transplant.
• A clinical trial of chemotherapy with or without a monoclonal antibody.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with childhood acute myeloid leukemia in remission ².

Treatment of recurrent childhood acute myeloid leukemia (AML) may include the following:

• Combination chemotherapy
• Combination chemotherapy and stem cell transplant.
• A clinical trial of a new anticancer drug.
• A clinical trial of a new monoclonal antibody.
• A clinical trial of stem cell transplant using different sources of stem cells.

Treatment of recurrent acute promyelocytic leukemia may include all-trans retinoic acid (ATRA) or arsenic trioxide therapy

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with recurrent childhood acute myeloid leukemia ³.

Treatment of acute promyelocytic leukemia may include the following:

• All-trans retinoic acid (ATRA) plus chemotherapy.
• Arsenic trioxide therapy.
• Combination chemotherapy.
• A clinical trial of chemotherapy and ATRA with or without arsenic trioxide.
• A clinical trial of a monoclonal antibody with ATRA.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with childhood acute promyelocytic leukemia (M3) ⁴.

Treatment of AML in children who have Down syndrome may include the following:

• Combination chemotherapy.
• A clinical trial of lower- dose chemotherapy.

Treatment for childhood chronic myelogenous leukemia may include the following:

• Stem cell transplant.
• Drug therapy with Gleevec.
• A clinical trial of Gleevec therapy with interferon or chemotherapy.
• A clinical trial of stem cell transplant using lower doses of chemotherapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with childhood chronic myelogenous leukemia ⁵.

Treatment of juvenile myelomonocytic leukemia may include the following:

• Stem cell transplant.
• A clinical trial of new combinations of chemotherapy and stem cell transplant.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with juvenile myelomonocytic leukemia ⁶.

Transient myeloproliferative disorder (TMD) usually goes away on its own. For TMD that does not go away on its own, treatment may include the following:

• Transfusion therapy.
• Leukapheresis.
• Chemotherapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with acute myeloid leukemia/transient myeloproliferative disorder ⁷.

Treatment of myelodysplastic syndromes may include the following:

• Stem cell transplant.
• Combination chemotherapy.
• A clinical trial of a new anticancer drug.

Supportive care treatments are used to manage problems caused by the disease, such as infection, bleeding, and anemia.

If the myelodysplastic syndrome progresses to acute myeloid leukemia (AML), treatment will be the same as treatment for the newly diagnosed patient with AML.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with childhood myelodysplastic syndromes ⁸.

Glossary Terms

A quickly progressing disease in which too many immature white blood cells (not lymphocytes) are found in the blood and bone marrow. Also called AML, acute myelogenous leukemia, acute myeloblastic leukemia, acute nonlymphocytic leukemia, and ANLL.

APL. An aggressive (fast-growing) type of acute myeloid leukemia in which there are too many immature blood-forming cells in the blood and bone marrow. It is usually marked by an exchange of parts of chromosomes 15 and 17. Also called APL and promyelocytic leukemia.

ATRA. A form of vitamin A that is made by the body and can also be made in the laboratory. It is used to treat acute promyelocytic leukemia, usually together with other drugs, and to treat acne. It is being studied in the treatment and prevention of other types of cancer. Also called ATRA, tretinoin, retinoic acid, and vitamin A acid.

A quickly progressing disease in which too many immature white blood cells (not lymphocytes) are found in the blood and bone marrow. Also called acute myelogenous leukemia, acute myeloid leukemia, acute myeloblastic leukemia, acute nonlymphocytic leukemia, and ANLL.

A condition in which the number of red blood cells is below normal.

A drug used to treat acute promyelocytic leukemia (APL) that has not gotten better or that has come back after treatment with other anticancer drugs. It is also being studied in the treatment of other types of cancer. Also called Trisenox.

Treatment with drugs that kill cancer cells.

CML. A slowly progressing disease in which too many white blood cells (not lymphocytes) are made in the bone marrow. Also called CML, chronic granulocytic leukemia, and chronic myeloid leukemia.

A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called a clinical study.

Chemotherapy or radiation therapy given to the central nervous system (CNS) as a preventive treatment. It kills cancer cells that may be in the brain and spinal cord, even though no cancer has been detected there. Also called central nervous system sanctuary therapy, central nervous system prophylaxis, and CNS prophylaxis.

Treatment using more than one anticancer drug.

A type of high-dose chemotherapy often given as the second phase (after induction therapy) of a cancer treatment regimen for leukemia. Also called intensification therapy.

The process of identifying a disease by the signs and symptoms.

The amount of medicine taken, or radiation given, at one time.

A disorder caused by the presence of an extra chromosome 21 and characterized by mental retardation and distinguishing physical features.

Any substance, other than food, that is used to prevent, diagnose, treat or relieve symptoms of a disease or abnormal condition. Also refers to a substance that alters mood or body function, or that can be habit-forming or addictive, especially a narcotic.

A drug used to treat different types of leukemia and other cancers of the blood, gastrointestinal stromal tumors, skin tumors called dermatofibrosarcoma protuberans, and a rare condition called systemic mastocytosis. It is also being studied in the treatment of other types of cancer. Gleevec blocks the protein made by the bcr/abl oncogene. It is a type of tyrosine kinase inhibitor. Also called imatinib mesylate and STI571.

A malignant, green-colored tumor of myeloid cells (a type of immature white blood cell). This tumor is usually associated with myelogenous leukemia. Also called chloroma.

Invasion and multiplication of germs in the body. Infections can occur in any part of the body and can spread throughout the body. The germs may be bacteria, viruses, yeast, or fungi. They can cause a fever and other problems, depending on where the infection occurs. When the body’s natural defense system is strong, it can often fight the germs and prevent infection. Some cancer treatments can weaken the natural defense system.

A type of high-dose chemotherapy often given as the second phase (after induction therapy) of a cancer treatment regimen for leukemia. Also called consolidation therapy.

A biological response modifier (a substance that can improve the body's natural response to infections and other diseases). Interferons interfere with the division of cancer cells and can slow tumor growth. There are several types of interferons, including interferon-alpha, -beta, and -gamma. The body normally produces these substances. They are also made in the laboratory to treat cancer and other diseases.

Treatment in which anticancer drugs are injected into the fluid-filled space between the thin layers of tissue that cover the brain and spinal cord.

JMML. A rare form of childhood leukemia in which cancer cells often spread into tissues such as the skin, lung, and intestines. Also called JMML.

Removal of the blood to collect specific blood cells. The remaining blood is returned to the body.

A type of protein made in the laboratory that can locate and bind to substances in the body, including tumor cells. There are many kinds of monoclonal antibodies. Each monoclonal antibody is made to find one substance. Monoclonal antibodies are being used to treat some types of cancer and are being studied in the treatment of other types. They can be used alone or to carry drugs, toxins, or radioactive materials directly to a tumor.

A group of diseases in which the bone marrow does not make enough healthy blood cells. Also called preleukemia and smoldering leukemia.

A group of slow growing blood cancers, including chronic myelogenous leukemia, in which large numbers of abnormal red blood cells, white blood cells, or platelets grow and spread in the bone marrow and the peripheral blood.

The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called radiotherapy and irradiation.

Cancer that has recurred (come back), usually after a period of time during which the cancer could not be detected. The cancer may come back to the same place as the original (primary) tumor or to another place in the body. Also called recurrence.

A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although cancer still may be in the body.

The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.

A cell from which other types of cells develop. For example, blood cells develop from blood-forming stem cells.

A method of replacing immature blood-forming cells that were destroyed by cancer treatment. The stem cells are given to the person after treatment to help the bone marrow recover and continue producing healthy blood cells.

Care given to improve the quality of life of patients who have a serious or life-threatening disease. The goal of supportive care is to prevent or treat as early as possible the symptoms of a disease, side effects caused by treatment of a disease, and psychological, social, and spiritual problems related to a disease or its treatment. Also called palliative care, comfort care, and symptom management.

Treatment.

The infusion of components of blood or whole blood into the bloodstream. The blood may be donated from another person, or it may have been taken from the person earlier and stored until needed.