Maintenance therapies after consolidation chemo ?

Welcome to Connect @pefishback. It’s not uncommon for some patients who have completed induction/consolidation to be taking some form of maintenance meds. But not everyone requires them to stay in remission. It can depend on the risk factor for potential relapse, the type of cancer, genetic mutations and such.
What form of blood cancer were you being treated for? Has your doctor suggested post treatment?

Thanks @loribmt. I have acute myeloid leukemia, FLT3 negative and NPM1 positive. No unfavorable mutations of which I’m aware and no current plans for a BMT.

My doctor has so far indicated a preference to just watch and wait for potential relapses. I’d prefer a more proactive approach if possible and wondered if anyone in this support group, who has not undergone a BMT, has had experience with maintenance therapies.

Hi @pefishback. I’d say if you’ve gone through induction/consolidation and your doctor feels you’re a candidate for active surveillance instead of BMT or maintenance therapy, then enjoy the break from chemo! Let your body heal.

I occasionally mentor AML patients for my local hospital/oncology center. One of the patients, who has become one of my closest friends, had AML with similar diagnosis as yours. NPM1 positive, FLT3 Neg. She had her induction, consolidations and that was all she required…which made her really hesitant! She’s now 4 years out and healthy! No further meds only routine blood work every 3 months.

We have several members, @lindagi @sonieaml @dancouclanel4, and others, with AML whom have not had a BMT as their treatment, share their experiences in this discussion.

AML Successful Treatment
https://connect.mayoclinic.org/discussion/aml-successful-treatment/
I know and understand the underlying fear of the possibility of relapse. You’ve just gone through an epic journey with your chemo and now the prospect of ‘I’m all done?’ feels a bit incredulous. It’s difficult to move from patient, to survivor, to thriver and eventually to overcomer. At least those were the stages I personally felt. Slowly you’ll learn to believe that this is all working. And also, you’re not being left hanging out to dry. Your doctor will be monitoring you, through labs, on a regular schedule for any signs of relapse.

What chemo was used for your Induction/consolidation?

Thanks for such an informative and encouraging response. For induction, I was given what I hear referred to as the “7+3” regimen. I’m not sure, but I think the “7” was cytarabine. For consolidation, I received cytarabine, spread out over four hospital stays, spaced four weeks apart. For the last consolidation, the dosage was reduced a little bit. This may be because I had been admitted twice previously for neutropenic fevers between successive visits. Or perhaps because my numbers went so low after my third stay. I’m not sure.

I’m suspect you and I had the same 7+3 regimen: cyterabine (7) + Idarubicin (3). That’s not a reduced intensity treatment…we were full-on in battle.🤺 😅. My first round was administered during my initial 5 week stay at my local hospital, followed by consolidation rounds every 28 days until I had my bone marrow biopsy. Each subsequent round had my blood numbers recovering much slower than the last. And I also ended up in the hospital for neutropenic fevers. You were fortunate to have FLT3 negative as that one can tip the scales into post treatment. I had 3 mutations which, altogether, left me with no option but a BMT.

Your doctor feels comfortable with your treatment ending at this point. And like I said, they’ll keep monitoring your labs pretty closely for any hints of relapse. Have you had tests for MRD (minimal residual disease) and a follow-up bone marrow biopsy?

The biopsy and MRD test will likely take place at the end of the month. I anticipate my numbers will bottom out by the end of next week. (After the last stay, the platelet count went down to 1.)

Thanks again.