Bone marrow suppression during 7+3 is the intended effect of treatment, not a complication to be minimised. Clearing leukaemia cells from the marrow means temporarily clearing the marrow of healthy cells too.
7+3 Induction Chemotherapy — for Acute Leukaemia
7+3 is a chemotherapy regimen, not a single drug. The acronym describes when two medicines are given and implies a hospital admission that will last several weeks, not several days. Knowing what the terms mean makes it easier to prepare.
- A schedule, not a drug name — 7+3 describes when two specific drugs are given, not a single medicine.
- Weeks in hospital, not days — The chemotherapy runs for one week, but the admission lasts several weeks while blood counts recover.
- Blood counts will fall severely — This is an expected and managed part of treatment, not a complication.
- Consolidation follows if induction works — Achieving remission is the goal of induction — and the start of the next phase, not the end of treatment.
Medically reviewed by Dr. C. Raghavendra Reddy, Medical Oncologist, MBBS (Gold Medal) · DNB · DM (Medical Oncology, Gold Medal) · Last reviewed September 2026
7+3 is the standard induction regimen for acute myeloid leukaemia. The name describes the schedule: cytarabine is given by continuous drip for 7 days, and an anthracycline such as daunorubicin or idarubicin is given on the first 3 days. The treatment aims to push the disease into remission and requires a hospital admission of several weeks.
What do the terms on your family member's chart mean?
- 7+3
- The regimen is named for its schedule. Cytarabine is given as a continuous intravenous drip for 7 consecutive days. An anthracycline is given on each of the first 3 days.
- Cytarabine (Ara-C)
- One of the two drugs in the regimen. It is given as a continuous infusion over seven days and targets rapidly dividing cells.
- Anthracycline (daunorubicin or idarubicin)
- The drug given on the first three days. Which anthracycline is used depends on the treating team and the individual case.
- Induction
- The first and most intensive phase of leukaemia treatment. The aim is to reduce leukaemia cells in the bone marrow to a level that qualifies as remission.
- Nadir
- The point — usually in the second week of admission — when blood counts are at their lowest. Infection and bleeding risk are highest during nadir. It is expected and managed on the ward.
- Consolidation
- The treatment phase that follows successful induction. It aims to prevent the leukaemia from returning once remission has been confirmed by bone marrow testing.
How long is the hospital admission?
7+3 is not a day-care treatment. The drugs are given during the first week, but the admission continues while blood counts fall and then recover. This takes several weeks.
The typical stay runs around four to six weeks, though it varies and can be longer if complications arise. The ward team will update you week by week on progress and what to expect next.
What is consolidation chemotherapy and when does it happen?
Consolidation is the treatment phase that follows a successful induction. Once bone marrow tests confirm remission, the aim shifts from clearing the leukaemia to preventing it from returning.
Consolidation typically involves further cycles of chemotherapy — often including high-dose cytarabine — given as shorter admissions over several months. For some patients, a stem cell transplant forms part of the plan. Your haematologist will explain the options once induction results are available.
Who is 7+3 induction not suitable for?
Not every patient with acute myeloid leukaemia is a candidate for 7+3 induction, and patients with other leukaemia types are not candidates at all. Eligibility is decided by a haematologist on each individual case.
7+3 is typically not used in:
- Acute lymphoblastic leukaemia (ALL) — ALL is a different disease requiring different induction regimens.
- Acute promyelocytic leukaemia (APL, also called M3 AML) — APL has its own specific induction approach and is not treated with the standard 7+3 combination.
- Patients whose general fitness means they are unlikely to tolerate intensive induction and its side effects.
- Patients with significantly reduced heart function, as anthracyclines carry cardiac risk that must be assessed before treatment can begin.
- Some older patients, where a lower-intensity regimen may be preferred after individual assessment.
- AML arising from certain prior treatments, where alternative regimens may be recommended by NCCN or ESMO guidance.
What families should prepare before the admission
- Arrange leave from work and home responsibilities — the admission typically runs several weeks with no planned breaks.
- Bring previous scans, blood results and discharge summaries from any other hospital visited.
- Pack for a long stay: comfortable clothing, hygiene items, a phone charger and earphones.
- Tell the ward team about every medicine, supplement, herbal remedy and traditional preparation the patient is taking.
- Ask on day one which symptoms mean calling the ward immediately, and save that number in your phone.
- Identify a second family contact the ward can reach if the primary contact is unavailable.
What happens to blood counts during treatment?
Both drugs in 7+3 suppress the bone marrow. This is the point of the treatment — leukaemia cells live there — but it temporarily reduces the production of healthy blood cells too.
Counts typically reach their lowest point one to two weeks into the admission. At that stage your family member will need transfusions of red cells and platelets, and the team will give antibiotics if any sign of infection appears. The counts begin to recover as the marrow rebuilds over the following weeks.
Did you know?
The recovery of normal blood cell production — tracked through daily blood tests — is the clinical signal that the marrow is rebuilding. The admission continues until that recovery is confirmed.
Source: NCCN Guidelines for Acute Myeloid Leukaemia
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Frequently asked questions
Why does the stay last weeks when the drugs are only given for a few days?
The admission is long because the bone marrow suppression caused by the drugs takes several weeks to resolve. While blood counts are very low, your family member cannot independently produce enough red cells, platelets or white cells. Daily monitoring, transfusions and antibiotic cover are all part of what the inpatient admission provides. Leaving before counts have recovered to a safe level would mean going home without the daily safety checks that catch problems early.
Is 7+3 used for all types of leukaemia?
No. 7+3 is used specifically for acute myeloid leukaemia (AML). Acute lymphoblastic leukaemia, chronic leukaemias and lymphomas all require different regimens. Even within AML, a subtype called acute promyelocytic leukaemia (APL or M3) is treated with a different approach. Your haematologist will confirm which regimen is appropriate for the specific diagnosis and subtype.
What will my family member feel during the weeks of admission?
The drugs are given through an IV line and are not painful in the way an injection is. The weeks that follow typically involve fatigue, nausea and mouth sores, as well as the effects of low blood counts — easier bruising, tiredness and vulnerability to infection. Most of these are managed with medicines the ward team will start routinely. Fatigue tends to be most noticeable during nadir, when counts are at their lowest, usually in the second week.
What are the most serious risks during induction?
The most significant risks are severe infection and bleeding, both arising from bone marrow suppression. Your family member will be monitored daily with blood tests and will receive transfusions and antibiotics when needed. Anthracyclines also carry a risk to heart function, which is why a cardiac assessment is usually done before induction begins. Your haematologist will explain the specific risks relevant to your family member's individual case.
Can my family member come home at any point during induction?
Not during the main induction period. Blood counts need to recover to a safe level before discharge, and that takes several weeks. The ward team tracks counts daily and will tell you what needs to be achieved before discharge becomes possible. Any exception to this is a medical decision made by the treating team — it is not a standard part of the plan and carries real risk if counts are still very low.
What happens if the first induction does not achieve remission?
If a first induction does not achieve remission, a second induction using a different regimen is usually considered. The decision depends on the individual's fitness, the AML subtype and the bone marrow assessment findings. This is sometimes called salvage induction. It is a conversation your haematologist will have with you directly if it becomes relevant — and it is not a decision made until the first induction results are fully assessed.
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