Acute Myelogenous Leukemia Patient & Family Handbook

Cytogenetic Analysis Cytogenetic analysis is the process of analyzing changes in the chromosomes of leukemia cells. During this analysis, defects in the number and structure of these chromosomes (chromosomal abnormalities) are carefully assessed . It is important to note cytogenetic analysis for leukemia analyzes only the abnormalities of the chromosomes in the leukemia cells, not other cells in the body. Abnormalities in the chromosomal number and structure of leukemia cells do not imply that your child has a genetic problem. Cytogenetic analysis of these leukemia cells is important in determining the best treatment for your child’s leukemia. Lumbar Puncture The central nervous system (brain, spinal cord, and cerebrospinal fluid [CSF]) is a hiding place for leukemia cells. To determine whether leukemia has spread into the central nervous system, your child must undergo a lumbar puncture, also referred to as a spinal tap. In a lumbar puncture, a small needle is inserted into the back between the lower spinal bones (vertebrae) to obtain a sample of CSF. The fluid is sent to a laboratory and examined for any evidence of leukemia. The majority of children require sedation to remain still during this procedure. Most of the time, the lumbar puncture is performed at the same time as the bone marrow aspiration and biopsy. The results of the lumbar puncture will help physicians determine the type of treatment your child will receive. Venous Access Device A venous access device (VAD), sometimes called a central line, is an intravenous (IV) catheter that may be used for the duration of your child’s therapy. It is inserted during surgery when your child is under heavy sedation or general anesthesia. It can be used to administer medication, chemotherapy (cancer-fighting drugs), blood products, and nutritional support. It also may be used to draw blood for testing purposes. The VAD may remain in your child for the duration of treatment and will be removed surgically when it is no longer needed. n HOW IS AML TREATED? Treatment for AML is determined according to the risk assignment for your child’s disease. Risk assignment is based on the type of AML your child has, any risk factors identified during their initial bone marrow evaluation (cytogenetic analysis results), and their response to the first round of chemotherapy. Some children may have the opportunity to take part in a clinical trial that is testing newer drugs to treat AML. Chemotherapy All children with AML are treated with chemotherapy. The chemotherapy drugs used to treat AML typically are administered intravenously (through the VAD). Depending on the drug used, it may be given rapidly or over a prolonged period of time. Children with AML are hospitalized to receive their medications and frequently remain hospitalized for several weeks. The chemotherapy used to treat AML is very strong and significantly lowers blood counts (the number of RBCs, WBCs, or platelets), putting your child at risk for infections, bleeding, and other complications. Following the intense chemotherapy, your child likely will remain in the hospital until their blood counts begin to recover. In an effort to prevent serious infections, your child likely will be on medications to help prevent infections from bacteria and fungus. If your child has a fever or any concern for infection, they will require evaluation by the medical team and hospitalization for observation and management of any possible infections.

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