Tratamiento de la leucemia mieloide aguda y otros cánceres mieloides

Childhood acute myeloid leukemia (AML) is a type of cancer in which the bone marrow makes a large number of abnormal blood cells.

Childhood acute myeloid leukemia (AML) is a cancer of the blood and bone marrow. AML is also called acute myelogenous leukemia and acute nonlymphocytic leukemia. Cancers that are acute usually get worse quickly if they are not treated. Cancers that are chronic usually get worse slowly.

Ampliar

Anatomy of the bone. The bone is made up of compact bone, spongy bone, and bone marrow. Compact bone makes up the outer layer of the bone. Spongy bone is found mostly at the ends of bones and contains red marrow. Bone marrow is found in the center of most bones and has many blood vessels. There are two types of bone marrow: red and yellow. Red marrow contains blood stem cells that can become red blood cells, white blood cells, or platelets. Yellow marrow is made mostly of fat.

This summary is about the treatment of childhood AML, transient abnormal myelopoiesis, childhood acute promyelocytic leukemia, juvenile myelomonocytic leukemia, childhood chronic myelogenous leukemia, and childhood myelodysplastic syndromes. For information about the treatment of childhood acute lymphoblastic leukemia, see Childhood Acute Lymphoblastic Leukemia Treatment.

Leukemia and other diseases of the blood and bone marrow may affect red blood cells, white blood cells, and platelets.

In healthy children, the bone marrow makes blood stem cells (immature cells) that become mature blood cells over time. A blood stem cell may become a myeloid stem cell or a lymphoid stem cell. A lymphoid stem cell becomes a type of white blood cell.

A myeloid stem cell becomes one of three types of mature blood cells:

• Red blood cells that carry oxygen and other substances to all tissues of the body.
• Granulocytes, which are white blood cells that help fight infection and disease.
• Platelets that form blood clots to stop bleeding.

Ampliar

Blood cell development. A blood stem cell goes through several steps to become a red blood cell, platelet, or white blood cell.

In AML, the myeloid stem cells usually become a type of immature white blood cell called myeloblasts (or myeloid blasts). The myeloblasts, or leukemia cells, in AML are abnormal and do not become healthy white blood cells. The leukemia cells can build up in the blood and bone marrow so there is less room for healthy white blood cells, red blood cells, and platelets. This may lead to infection, anemia, or easy bleeding.

The leukemia cells can spread outside the blood to other parts of the body, including the central nervous system (brain and spinal cord), skin, and gums. Sometimes leukemia cells form a solid tumor called a myeloid sarcoma. Myeloid sarcoma is also called granulocytic sarcoma or chloroma.

Other myeloid diseases can affect the blood and bone marrow.

Chronic myelogenous leukemia (CML)

CML often begins in an early myeloid blood cell when a certain gene change occurs. A section of genes, that includes the ABL gene, on chromosome 9 changes place with a section of genes on chromosome 22, which has the BCR gene. This makes a very short chromosome 22 (called the Philadelphia chromosome) and a very long chromosome 9. An abnormal BCR-ABL gene is formed on chromosome 22. The BCR-ABL gene tells the blood cells to make too much of a protein called tyrosine kinase. Tyrosine kinase causes too many abnormal white blood cells (leukemia cells) to be made in the bone marrow. The leukemia cells can build up in the blood and bone marrow so there is less room for healthy white blood cells, red blood cells, and platelets. This can lead to infection, anemia, or easy bleeding. CML is rare in children.

Ampliar

The Philadelphia (Ph) chromosome is an abnormal chromosome that is made when pieces of chromosomes 9 and 22 break off and trade places. The ABL1 gene from chromosome 9 joins to the BCR gene on chromosome 22 to form the BCR:: ABL1 fusion gene. The changed chromosome 22 with the fusion gene on it is called the Ph chromosome.

AML or MDS may occur after treatment with certain chemotherapy drugs and/or radiation therapy.

Cancer treatment with certain chemotherapy drugs and/or radiation therapy may cause therapy-related AML (t-AML) or therapy-related MDS (t-MDS). The risk of these therapy-related myeloid diseases depends on the total dose of the chemotherapy drugs used and the radiation dose and treatment field. Some patients also have an inherited risk for t-AML and t-MDS. These therapy-related diseases usually occur within 7 years after treatment, but are rare in children.

The risk factors for childhood acute myeloid leukemia and other myeloid malignancies are similar.

Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. Talk with your child’s doctor if you think your child may be at risk. These and other factors may increase the risk of childhood AML, APL, JMML, CML, and MDS:

• Having a brother or sister, especially a twin, with leukemia.
• Having a personal history of bone marrow failure.
• Having a personal history of MDS.
• Past treatment with chemotherapy or radiation therapy.
• Being exposed to ionizing radiation or chemicals such as benzene.
• Tener cierta síndromes or inherited disorders, such as:
  • Down syndrome.
  • Aplastic anemia.
  • Fanconi anemia.
  • Neurofibromatosis tipo 1.
  • Noonan syndrome.
  • Shwachman-Diamond syndrome.
  • Anemia de Diamond-Blackfan.
  • Dyskeratosis congenita.
  • Síndrome de Li-Fraumeni.

Signs and symptoms of childhood acute myeloid leukemia and other myeloid malignancies include fever, feeling tired, and easy bleeding or bruising.

These and other signs and symptoms may be caused by childhood AML, APL, JMML, CML, or MDS or by other conditions. Check with a doctor if your child has any of the following:

• Fever with or without an infection.
• Drenching night sweats.
• Dificultad para respirar
• Weakness, feeling tired, or looking pale.
• Easy bruising or bleeding.
• Petechiae (flat, pinpoint spots under the skin caused by bleeding).
• Bone or joint pain.
• Pain or feeling of fullness below the ribs.
• Painless lumps in the neck, underarm, stomach, groin, or other parts of the body. In childhood AML, these lumps, called leukemia cutis, may be blue or purple.
• Painless lumps that are sometimes around the eyes. These lumps, called myeloid sarcomas, are sometimes seen in childhood AML and may be blue-green.
• An eczema-like skin rash.
• Loss of appetite or weight loss.
• Headache, trouble seeing, or confusion.

The signs and symptoms of TAM may include the following:

• Swelling all over the body.
• Dificultad para respirar
• Dificultad para respirar.
• Increased heart rate.
• Weakness, feeling tired, or looking pale.
• Easy bleeding or bruising.
• Petechiae (flat, pinpoint spots under the skin caused by bleeding).
• Pain below the ribs.
• Skin rash.
• Jaundice (yellowing of the skin and whites of the eyes).

Sometimes TAM does not cause any symptoms at all and is diagnosed after a routine blood test.

Tests that examine the blood and bone marrow are used to diagnose and find any spread of childhood acute myeloid leukemia and other myeloid malignancies.

Se pueden utilizar las siguientes pruebas y procedimientos:

• Examen físico e historial de salud.: examen del cuerpo para comprobar los signos generales de salud, incluida la detección de signos de enfermedad, como bultos o cualquier otra cosa que parezca poco común. También se tomará nota de los hábitos de salud del paciente y de sus enfermedades y tratamientos anteriores.
• Complete blood count (CBC) with differential: es un procedimiento en el que se extrae una muestra de sangre y se examina lo siguiente:
  • The number of red blood cells and platelets.
  • The number and type of white blood cells.
  • La parte de la muestra de sangre que está compuesta por glóbulos rojos.
  • The amount of hemoglobin (the protein that carries oxygen) in the red blood cells.
  Ampliar

  

  Hemograma completo. La sangre se extrae introduciendo una aguja en una vena y dejando que la sangre fluya hacia un tubo. La muestra de sangre se envía al laboratorio y se cuentan los glóbulos rojos, los glóbulos blancos y las plaquetas. El hemograma se utiliza para analizar, diagnosticar y controlar muchas enfermedades diferentes.
  

• Radiografía de tórax: radiografía de los órganos y huesos del interior del tórax. Una radiografía es un tipo de haz de energía que puede atravesar el cuerpo y plasmarse en una película, generando una imagen de áreas internas del cuerpo.
• Una biopsia: La extracción de células o tejidos para que puedan ser vistos bajo un microscopio por un un patólogo to check for signs of cancer. Biopsies that may be done include the following:
  • Bone marrow aspiration and biopsy: La extracción de médula ósea y un pequeño trozo de hueso mediante la inserción de una aguja hueca en el hueso de la cadera o esternón.
    Ampliar

    

    Aspiración y biopsia de médula ósea: después de anestesiar una pequeña área de piel, se inserta una aguja de biopsia en el hueso de la cadera del niño. Se extraen muestras de sangre, hueso y médula ósea para examinarlas con un microscopio.
    

  • Tumor biopsy for AML: The removal of cells or tissues from a lump in the testicles, ovaries, or skin using a needle. This may be done if the doctor suspects the leukemia cells may have formed a solid tumor called a myeloid sarcoma.
• Immunophenotyping: A laboratory test that uses antibodies to identify cancer cells based on the types of antigens or markers on the surface of the cells. This test is used to help diagnose specific types of leukemia.
• Cytogenetic analysis: A laboratory test in which the chromosomes of cells in a sample of blood or bone marrow are counted and checked for any changes, such as broken, missing, rearranged, or extra chromosomes. Changes in certain chromosomes may be a sign of cancer. Cytogenetic analysis is used to help diagnose cancer, plan treatment, or find out how well treatment is working.

  The following test is a type of cytogenetic analysis:

  • FISH (fluorescence in situ hybridization): A laboratory test used to look at and count genes or chromosomes in cells and tissues. Pieces of DNA that contain fluorescent dyes are made in the laboratory and added to a sample of a patient’s cells or tissues. When these dyed pieces of DNA attach to certain genes or areas of chromosomes in the sample, they light up when viewed under a fluorescent microscope. The FISH test is used to help diagnose cancer and help plan treatment.
• Molecular testing: A laboratory test to check for certain genes, proteins, or other molecules in a sample of tissue, blood, or bone marrow. Molecular tests also check for certain changes in a gene or chromosome that may cause or affect the chance of developing AML. A molecular test may be used to help plan treatment, find out how well treatment is working, or make a prognosis.
• Lumbar puncture: A procedure used to collect a sample of cerebrospinal fluid (CSF) from the spinal column. This is done by placing a needle between two bones in the spine and into the CSF around the spinal cord and removing a sample of the fluid. The sample of CSF is checked under a microscope for signs that leukemia cells have spread to the brain and spinal cord. This procedure is also called an LP or spinal tap.
  Ampliar

  

  Lumbar puncture. A patient lies in a curled position on a table. After a small area on the lower back is numbed, a spinal needle (a long, thin needle) is inserted into the lower part of the spinal column to remove cerebrospinal fluid (CSF, shown in blue). The fluid may be sent to a laboratory for testing.
  

Existen factores que influyen en el pronóstico (es decir, la posibilidad de recuperación) y en las opciones de tratamiento disponibles.

The prognosis and treatment options for childhood acute myeloid leukemia (AML) depend on the following:

• The age of the child when the cancer is diagnosed.
• The race or ethnic group of the child.
• Whether the child is greatly overweight.
• Number of white blood cells in the blood at diagnosis.
• Whether the AML occurred after previous cancer treatment.
• The subtype of AML.
• Whether there are certain chromosome or gene changes in the leukemia cells.
• Whether the child has Down syndrome. Most children with AML and Down syndrome can be cured of their leukemia when diagnosed before age 4 years.
• Whether the leukemia is in the central nervous system (brain and spinal cord).
• How quickly the leukemia responds to treatment.
• Whether the AML is newly diagnosed (untreated) or has recurred after treatment.
• The length of time since treatment ended, for AML that has recurred.

The prognosis and treatment options for childhood acute promyelocytic leukemia (APL) depends on the following:

• Number of white blood cells in the blood at diagnosis.
• Whether there are certain chromosome or gene changes in the leukemia cells.
• Whether the APL is newly diagnosed (untreated) or has recurred after treatment.

The prognosis and treatment options for juvenile myelomonocytic leukemia (JMML) depend on the following:

• The age of the child when the cancer is diagnosed.
• The type of gene affected and the number of genes that have changes.
• How many platelets are in the blood after treatment.
• How much hemoglobin is in the blood after treatment.
• Whether the JMML is newly diagnosed (untreated) or has recurred after treatment.

The prognosis and treatment options for childhood chronic myelogenous leukemia (CML) depend on the following:

• How long it has been since the patient was diagnosed.
• How many blast cells are in the blood.
• Whether and how fully the blast cells disappear from the blood and bone marrow after therapy has started.
• Whether the CML is newly diagnosed (untreated) or has recurred after treatment.

The prognosis and treatment options for myelodysplastic syndromes (MDS) depend on the following:

• Whether the MDS was caused by previous cancer treatment.
• How low the numbers of red blood cells, white blood cells, or platelets are.
• Whether the MDS is newly diagnosed (untreated) or has recurred after treatment.

There is no standard staging system for childhood acute myeloid leukemia and other myelogenous malignancies.

The extent or spread of cancer is usually described as stages. Instead of stages, treatment is based on one or more of the following:

• The type of disease or the subtype of AML.
• Whether leukemia has spread outside the blood and bone marrow.
• Whether the disease is newly diagnosed, in remission, or recurrent.

Newly diagnosed childhood AML

Newly diagnosed childhood AML is cancer that has not been treated except to relieve signs and symptoms such as fever, bleeding, or pain, and has one of the following:

• More than 20% of the cells in the bone marrow are blasts (leukemia cells).

  o

• Less than 20% of the cells in the bone marrow are blasts and there is a certain change in the chromosome.

Childhood AML in remission

In childhood AML in remission, the disease has been treated and the following are found:

• The complete blood count is almost normal.
• Less than 5% of the cells in the bone marrow are blasts (leukemia cells).
• There are no signs or symptoms of leukemia in the brain, spinal cord, or other parts of the body.

Sometimes childhood acute myeloid leukemia and other myeloid malignancies do not respond to treatment or come back after treatment.

Refractory leukemia is cancer that does not respond to treatment.

Recurrent leukemia is cancer that has recurred (come back) after it has been treated. The cancer may come back in the blood and bone marrow or in other parts of the body, such as the central nervous system (brain and spinal cord).

There are different types of treatment for children with acute myeloid leukemia and other myeloid malignancies.

Different types of treatment are available for children with acute myeloid leukemia (AML), transient abnormal myelopoiesis (TAM), acute promyelocytic leukemia (APL), juvenile myelomonocytic leukemia (JMML), chronic myelogenous leukemia (CML), and myelodysplastic syndromes (MDS). Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.

Because AML and other myeloid disorders are rare in children, taking part in a clinical trial should be considered. Some clinical trials are open only to patients who have not yet started treatment.

Treatment is planned by a team of health care providers who are experts in treating childhood leukemia and other diseases of the blood.

Treatment will be overseen by a pediatric oncologist, a doctor who specializes in treating children with cancer. The pediatric oncologist works with other health care providers who are experts in treating children with leukemia and who specialize in certain areas of medicine. These may include the following specialists:

• Pediatra.
• Hematólogo.
• Medical oncologist.
• cirujano pediátrico.
• Oncólogo radioterapeuta.
• Neurologist.
• Neuropathologist.
• Neuroradiologist.
• Enfermera pediátrica especialista.
• Trabajador social.
• Especialista en rehabilitación.
• Psicólogo.

The treatment of childhood AML and other myeloid malignancies usually has two phases.

The treatment of childhood AML is done in phases:

• Induction therapy: This is the first phase of treatment. The goal is to kill the leukemia cells in the blood and bone marrow. This puts the leukemia into remission.
• Consolidation/intensification therapy: This is the second phase of treatment. It begins once the leukemia is in remission. The goal of therapy is to kill any remaining leukemia cells that are hiding and may not be active but could begin to regrow and cause a relapse.

Treatment called central nervous system (CNS) prophylaxis therapy may be given during the induction phase of therapy. Because standard doses of chemotherapy may not reach leukemia cells in the CNS (brain and spinal cord), the leukemia cells are able to hide in the CNS. Intrathecal chemotherapy is able to reach leukemia cells in the CNS. It is given to kill the leukemia cells and lessen the chance the leukemia will recur (come back).

The treatment of childhood APL includes a third phase called maintenance. The goal of maintenance is to kill any remaining leukemia cells that may regrow and cause a relapse. Often the cancer treatments are given in lower doses than those used during the remission induction and consolidation/intensification phases.

Seven types of standard treatment may be used for childhood AML and other myeloid malignancies.

Quimioterapia

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid (intrathecal chemotherapy), an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). Combination chemotherapy is treatment using more than one chemotherapy drug.

The way the chemotherapy is given depends on the type of cancer being treated. In AML, chemotherapy given by mouth, vein, or into the cerebrospinal fluid is used.

In AML, the leukemia cells may spread to the brain and/or spinal cord. Chemotherapy given by mouth or vein to treat AML may not cross the blood-brain barrier to get into the fluid that surrounds the brain and spinal cord. Instead, chemotherapy is injected into the fluid-filled space to kill leukemia cells that may have spread there (intrathecal chemotherapy).

Ampliar

Intrathecal chemotherapy. Anticancer drugs are injected into the intrathecal space, which is the space that holds the cerebrospinal fluid (CSF, shown in blue). There are two different ways to do this. One way, shown in the top part of the figure, is to inject the drugs into an Ommaya reservoir (a dome-shaped container that is placed under the scalp during surgery; it holds the drugs as they flow through a small tube into the brain). The other way, shown in the bottom part of the figure, is to inject the drugs directly into the CSF in the lower part of the spinal column, after a small area on the lower back is numbed.

See Drugs Approved for Acute Myeloid Leukemia for more information.

Stem cell transplant

Chemotherapy is given to kill cancer cells or other abnormal blood cells. Healthy cells, including blood-forming cells, are also destroyed by the cancer treatment. Stem cell transplant is a treatment to replace the blood-forming cells. Stem cells (immature blood cells) are removed from the blood or bone marrow of the patient or a donor and are frozen and stored. After the patient completes chemotherapy, the stored stem cells are thawed and given to the patient through an infusion. These reinfused stem cells grow into (and restore) the body's blood cells.

Ampliar

Trasplante de células madre de donante. (Paso 1): De cuatro a cinco días antes de la recolección de células madre del donante, este recibe un medicamento para aumentar la cantidad de células madre que circulan por el torrente sanguíneo (este paso no se ilustra). Luego, las células madre responsables de la producción de sangre se extraen del donante a través de una vena principal en su brazo. La sangre fluye a través de una máquina de aféresis que elimina las células madre. El resto de la sangre regresa al donante por una vena en el otro brazo. (Paso 2): El paciente recibe quimioterapia para eliminar las células cancerosas y preparar el cuerpo para las células madre del donante. También puede recibir radioterapia (no se ilustra). (Paso 3): El paciente recibe una infusión de las células madre del donante.

Se están probando nuevos tipos de tratamiento en ensayos clínicos.

Esta sección resume los tratamientos que se están estudiando en ensayos clínicos. Es posible que no se mencionen todos los tratamientos nuevos que se están estudiando. La información sobre los ensayos clínicos está disponible en el sitio web del NCI.

Treatment for childhood acute myeloid leukemia and other myeloid malignancies may cause side effects.

Para obtener más información sobre los efectos secundarios que aparecen durante el tratamiento del cáncer, consulte la sección Efectos secundarios.

Regular follow-up exams are very important. Side effects from cancer treatment that begin after treatment and continue for months or years are called late effects. Late effects of cancer treatment may include the following:

• Physical problems that affect the following:
  • Heart, lung, or endocrine function.
  • Bone development.
  • Fertility (ability to have children).
  • Energy level.
• Cambios en el estado de ánimo, los sentimientos, el pensamiento, el aprendizaje o la memoria.
• Second cancers (new types of cancer), such as breast cancer.

Some late effects may be treated or controlled. It is important that parents of children who are treated for AML or other blood diseases talk with their child's doctors about the effects cancer treatment can have on their child. (See the PDQ summary on Late Effects of Treatment for Childhood Cancer for more information).

Los pacientes pueden valorar la posibilidad de participar en un ensayo clínico.

Para algunos pacientes, participar en un ensayo clínico puede ser la mejor opción de tratamiento. Los ensayos clínicos son parte del proceso de investigación del cáncer y se realizan para determinar si los nuevos tratamientos para el cáncer son seguros y eficaces o mejores que el tratamiento estándar.

Muchos de los tratamientos estándar actuales para el cáncer se basan en ensayos clínicos anteriores. Los pacientes que participan en un ensayo clínico pueden recibir el tratamiento estándar o ser de los primeros en recibir uno nuevo.

Los pacientes que participan en ensayos clínicos también ayudan a mejorar la forma en que se tratará el cáncer en el futuro. Incluso cuando los ensayos clínicos no conducen a nuevos tratamientos efectivos, suelen responder a preguntas clave y contribuir de forma significativa al avance de la investigación.

Los pacientes pueden participar en ensayos clínicos antes, durante o después de comenzar su tratamiento del cáncer.

Algunos ensayos clínicos sólo incluyen a pacientes que aún no han recibido tratamiento. Otros ensayos prueban tratamientos para pacientes cuyo cáncer no ha mejorado. También hay ensayos clínicos que prueban nuevas formas de evitar que el cáncer reaparezca o de reducir los efectos secundarios del tratamiento del cáncer.

Se están realizando ensayos clínicos en muchas partes del país. Puede encontrar información sobre los ensayos clínicos respaldados por el NCI en la página web de búsqueda de ensayos clínicos del NCI. Puede encontrar ensayos clínicos respaldados por otras organizaciones en el sitio web ClinicalTrials.gov.

Pueden ser necesarias pruebas de seguimiento.

A medida que su hijo se somete al tratamiento, se le harán pruebas o controles de seguimiento. Es posible que se repitan algunas pruebas que se realizaron para diagnosticar o estadificar el cáncer para ver en qué medida está funcionando bien el tratamiento. Las decisiones sobre si continuar, cambiar o suspender el tratamiento pueden basarse en los resultados de estas pruebas.

Algunas de las pruebas se seguirán realizando periódicamente después de que finalice el tratamiento. Los resultados de estas pruebas pueden mostrar si la afección de su hijo ha cambiado o si el cáncer ha reaparecido (recaído).

Acerca del PDQ

El Physician Data Query (PDQ) es la base de datos integral sobre el cáncer del National Cancer Institute (NCI). La base de datos del PDQ contiene resúmenes con la última información publicada sobre prevención, detección, genética, tratamiento, atención médica de apoyo y medicina complementaria y alternativa relacionada con el cáncer. La mayoría de los resúmenes se redactan en dos versiones. Las versiones para profesionales de la salud contienen información detallada escrita en lenguaje técnico. Las versiones para pacientes están redactadas en un lenguaje fácil de entender y no tan técnico. Ambas versiones contienen información correcta y actualizada sobre el cáncer. La mayoría de las versiones también están disponibles en español.

El PDQ es un servicio del NCI. El NCI es parte de los Institutos Nacionales de Salud (NIH), que son el centro de investigación biomédica del gobierno federal. Los resúmenes del PDQ se basan en una revisión independiente de la literatura médica. No son declaraciones de políticas del NCI ni de los NIH.

Propósito de este resumen

This PDQ cancer information summary has current information about the treatment of childhood acute myeloid leukemia and other myeloid malignancies. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.

Revisores y actualizaciones

Los consejos editoriales escriben los resúmenes de información sobre el cáncer del PDQ y los mantienen actualizados. Estos consejos están formados por equipos de especialistas en el tratamiento del cáncer y otras especialidades relacionadas con esta enfermedad. Los resúmenes se revisan periódicamente y se modifican cuando hay información nueva. La fecha de actualización al pie de cada resumen indica cuándo se realizó el cambio más reciente.

La información de este resumen para pacientes procede de la versión para profesionales de la salud, la cual el Consejo editorial del PDQ sobre el tratamiento pediátrico revisa y actualiza de forma periódica según sea necesario.

Información sobre ensayos clínicos

Un ensayo clínico es un estudio para responder a una pregunta científica como, por ejemplo, si un tratamiento es mejor que otro. Los ensayos se basan en estudios anteriores y en lo aprendido en el laboratorio. Cada ensayo responde a determinadas preguntas científicas que permiten encontrar nuevas y mejores formas de ayudar a los pacientes con cáncer. Durante los ensayos clínicos de tratamiento, se recopila información sobre los efectos de un nuevo tratamiento y su eficacia. Si un ensayo clínico demuestra que un nuevo tratamiento es mejor que uno que se utiliza actualmente, el nuevo tratamiento puede convertirse en “estándar”. Los pacientes pueden valorar la posibilidad de participar en un ensayo clínico. Algunos ensayos clínicos solo están abiertos a pacientes que no hayan iniciado el tratamiento.

Los ensayos clínicos se pueden encontrar en línea en el sitio web del NCI. Para obtener más información, llame al Servicio de Información sobre el Cáncer (CIS, por sus siglas en inglés), el centro de contacto del NCI, al 1-800-4-CANCER (1-800-422-6237).

Permiso de uso de este resumen

Physician Data Query (PDQ, por sus siglas en inglés) es una marca registrada. Se autoriza el libre uso del contenido de los documentos del PDQ como texto. Sin embargo, no se podrá identificar como un resumen de información sobre cáncer del PDQ del NCI, salvo que se reproduzca en su totalidad y se actualice con regularidad. Por otra parte, se permite que los autores incluyan una oración como “en el resumen del PDQ del NCI sobre la prevención del cáncer de mama se describen, de manera concisa, los siguientes riesgos: [incluir fragmento del resumen]”.

La forma recomendada para citar este resumen del PDQ es:

PDQ® Pediatric Treatment Editorial Board. PDQ Childhood Acute Myeloid Leukemia/Other Myeloid Malignancies Treatment. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: https://www.cancer.gov/types/leukemia/patient/child-aml-treatment-pdq. Accessed <MM/DD/YYYY>. [PMID: 26389303]

Las imágenes de este resumen se utilizan con el permiso del autor, artista y/o editorial para uso exclusivo en los resúmenes del PDQ. Si desea usar una imagen de un resumen del PDQ sin incluir el resumen completo, debe obtener autorización del propietario. El National Cancer Institute no puede otorgar dicho permiso. Para obtener más información sobre el uso de las imágenes de este resumen o de otras ilustraciones relacionadas con el cáncer, consulte Visuals Online, una colección de más de 3,000 imágenes científicas.

Descargo de responsabilidad

La información de estos resúmenes no debe utilizarse para tomar decisiones sobre reembolsos de seguros. Puede encontrar más información sobre la cobertura de seguros en Cancer.gov en la página Manejo de la atención del cáncer.

Contáctenos

Puede encontrar más información sobre cómo contactarnos o recibir ayuda en el sitio web Cancer.gov en la página Comuníquese con el NCI. También puede enviar sus preguntas a Cancer.gov en el apartado Escríbanos del sitio web.