Supportive treatment during this period includes blood and platelet transfusions and intravenous antibiotic treatment. Because of the intensive supportive treatment required, therapy for AML is given in the hospital, with the duration of hospitalization ranging from four to six weeks.
Investigational
• Different combinations of chemotherapy agents such as mitoxantrone and etoposide , amsacrine (AMSA) and
higher doses of Cytosar alone or carboplatinum and Cytosar are being evaluated. The use of purine nucleotides
such as 2-chlorodeoxyadenosine (2-CdA) is also under investigation for patients with acute myeloblastic
leukemia. All combinations have the common side effects of bone marrow suppression with resulting low
white blood cell and platelet counts. The benefits of treatment with these newer combinations are not yet clear.
• Treatment with growth factors such as GM-CSF (granulocyte/macrophage colony stimulating factor) or
G-CSF (granulocyte colony stimulating factor), or differentiation agents such as HMBA, or all-trans-retinoic
acid (ATRA) is also being evaluated. Patients with acute promyelocytic leukemia seem to have additional
benefits with the use of ATRA in combination with standard chemotherapy. It is hoped that treatment with
these agents will be less toxic and more effective than current chemotherapy programs.
• Another new concept in therapy involves using specific antibodies. These are proteins that bind to leukemia
cells and not to normal cells. The antibodies can carry some cell killing agent such as ricin or radioactive
isotopes directly to the leukemia cells, letting the agent kill the leukemia cells while sparing the normal white
