About acute myeloid leukaemia treatment side effects
Find out about the side effects of treatment for acute myeloid leukaemia (AML). You can find the following information
Side effects are unwanted effects that happen as a result of medical treatment. They vary depending on the type of treatment you’ve had and the treatment dose. They also vary from person to person.
There are a lot of immediate side effects with acute leukaemia treatment, including tiredness, an increased risk of infection, anaemia, bleeding and bruising, sickness, hair loss, a sore mouth and taste changes.
Long term side effects can come on months or years after your treatment finished. Again, the risk of these depends on the specific treatment that you had. Doctors are always working to reduce unwanted treatment effects. People treated for leukaemia these days are less likely to have long term effects than people treated in the past.
You can view and print the quick guides for all the pages in the treating AML section.
Side effects are unwanted things that happen to you as a result of medical treatment. The side effects that you may have and how severe they are depend on a number of factors including
- The type of treatment you have
- The combination of treatments you have
- The dose (amount) of the drug or radiotherapy
- The way you have treatment – as tablets or capsules, or by injection
- Your general health
- Your age
Many people are concerned about the possible side effects of treatment. All treatments cause some side effects. But side effects vary from one person to another.
For a treatment to become a standard treatment, the benefits need to outweigh any possible side effects. When researchers develop treatments they consider
- How well the treatment works
- The possible immediate and late side effects of the treatment
Treatments for leukaemia are continuing to improve, which means that more people are surviving with fewer side effects. There are medicines to help control most side effects that happen during or straight after treatment. Most of these effects stop when the treatment ends.
Side effects may be immediate or late.
Immediate side effects happen when you have the treatment or very soon after you finish. They depend on which treatments you have.
Common side effects of acute myeloid leukaemia treatment include
Tiredness with cancer
Fatigue (tiredness) is the most common side effect of treatment for cancer. For most people it gradually gets better over time. For some people it can be a longer term problem lasting several months or more. It is especially likely for people who have had a bone marrow transplant or stem cell transplant. Fatigue can be difficult and frustrating.
If fatigue is a problem for you, talk to your doctor or specialist nurse. There are lots of things that can help. First you may need tests to check that there isn’t an easily treatable cause of the tiredness, such as low thyroid hormone levels or anaemia. If there isn’t a direct cause, your doctor and nurse can suggest other things that may help.
For more information, read our page on tiredness and cancer.
Low resistance to infection
After your treatment it may take some time to build up your body’s ability to fight infection. After a transplant it usually takes between 6 months to a year for your immune system to recover. If you have graft versus host disease it can take even longer than this.
Contact your doctor if you have any symptoms that suggest you might have an infection. The symptoms of infection include
- A sore throat
- A high temperature
- Pain when passing urine
- A cough or breathlessness
- Flu like symptoms, such as aching muscles, tiredness, headaches, and feeling shivery
Children who have had treatment for leukaemia need to have their routine childhood vaccinations again. After a stem cell or bone marrow transplant, both adults and children need to have their vaccinations again. Each hospital has their own guidelines about when to vaccinate following a transplant.
There are various things you can do to try to avoid getting an infection.
Red blood cells contain haemoglobin which carries oxygen around the body. If the level of haemoglobin in your blood is low this is known as anaemia. You can feel very tired. You may also become breathless because the amount of oxygen carried around your body is lower. Some chemotherapy drugs can make you anaemic.
You can have a blood transfusion if your red blood cells are very low. After a transfusion you will feel more energetic, less tired and less breathless. Some people worry they may get an infection from a blood transfusion. All blood is now very carefully screened before it is used. The chances of getting an infection from a transfusion are tiny.
Risk of bruising and bleeding
Platelets help to clot the blood to prevent bleeding. If the number of platelets in your blood is low you may
- Bruise easily
- Bleed more than usual, even from small cuts or grazes
- Have nosebleeds
- Have a rash of small purple or red dots
The rash is called purpura and is caused by bleeding within the skin. If your platelet count is very low you will need to have a platelet transfusion in hospital. You have a drip of a clear fluid containing platelets go through into your vein. The new platelets start to work right away. You can have a platelet transfusion in hospital as often as you need one.
Feeling or being sick
Chemotherapy and radiotherapy can cause sickness. If you have total body irradiation (TBI) as part of a bone marrow transplant, it is very likely that you will feel and be sick if you don't have anti sickness drugs to prevent it. If you are having TBI, it is likely that you will be having chemotherapy as well. Having both these treatments makes it more likely that you will have some sickness.
Anti sickness drugs help to stop sickness. They can either be swallowed or injected depending on how you can take them.
For more information, read our page on sickness and cancer.
A sore mouth
Some types of chemotherapy can cause changes in the lining of your mouth and make it very sore. Some of these drugs can even cause mouth ulcers. Inflammation of the inside of your mouth is called mucositis. It can happen about 5 to 10 days after you start treatment. It usually gradually clears up 3 to 4 weeks after your treatment ends.
Sometimes mouth ulcers can get infected. Your doctor or nurse can give you treatment for this. If you are having drugs that are known to cause mouth ulcers, your nurse may give you mouth washes to help prevent infection. You have to use these regularly to get the most protection.
If your mouth is really sore, tell your doctor or nurse straight away. They can help to reduce the discomfort. Some people need strong painkillers to help control mouth pain so that they can eat and drink. With some drugs, some people even need to have morphine for a short time, because their mouths are so painful.
For more information, read this page on helpful hints for a sore mouth.
Some chemotherapy and biological therapy drugs can make food taste strange or may give you a metallic taste in your mouth. Food may taste
Your taste usually gradually goes back to normal when your treatment is over but it may take a few weeks. For more information, read this page on helpful hints for taste changes.
Changes in your heart muscle
Some cancer drugs can affect the way that your heart works. The drugs most likely to affect your heart are some chemotherapy drugs. The effect may be temporary but can sometimes be permanent.
Complete hair loss
Cancer drugs may cause
- Mild thinning of your hair
- Partial hair loss, or loss of patches of hair
- Complete hair loss (alopecia)
Generally, chemotherapy is the type of cancer drug treatment most likely to cause hair loss. Complete hair loss is very unlikely with any other type of treatment. But some other cancer drugs can cause hair thinning. We can't tell beforehand who will be affected or how badly. Some drugs are more likely to cause hair loss than others. Hair loss also depends on other factors such as
- The type of drug or combination of drugs you are taking
- The dose
- Your individual sensitivity to the drug
- Your drug treatment in the past
If your hair is going to fall out, it usually begins within 2 to 3 weeks after treatment starts. It is usually a gradual loss rather than a sudden one.
The good news is that your hair will grow back once your chemotherapy treatment has finished. Your hair may come back a different colour and may be more curly than before. It will probably grow back at the same rate as it grew before chemotherapy. Within 4 to 6 months after your treatment ends, you should have a good head of hair.
For more information, read our page on hair loss.
Cancer drugs may lower your sex drive for a while due to tiredness or other side effects. Your sex drive will usually go back to normal some time after the treatment ends.
Chemotherapy can lower the amount of hormones your ovaries make. It can also cause an early menopause and stop you from being able to become pregnant in the future. They may cause an early menopause for some women. You can talk to your doctor about this before your treatment. It is sometimes possible to store eggs or embryos before treatment.
Some types of chemotherapy can stop you from being able to father a child in the future. You can talk to your doctor about this as it is sometimes possible to collect and store sperm before treatment.
For more information, read our page on sex and fertility.
Diarrhoea is a common side effect of some chemotherapy drugs. It usually happens in the first few days of treatment and can be quite severe. If you have bad diarrhoea, remember that you can easily become dehydrated. It is important to drink plenty.
You may also want to apply soothing cream around your back passage (anus). The skin in this area can get very sore and even broken if you have severe diarrhoea.
For more information, read or page on diarrhoea.
Late effects are medical conditions that develop some years after treatment, for example
- Heart disease
- Clouding of the eye lens (cataracts)
- Not being able to have children (infertility)
As treatment improves and people survive longer we are finding out more about possible late effects. Because treatments have improved, the treatment that people have now is less likely to cause long term problems than treatment in the past.
Your doctor or specialist nurse talk to you about your particular risk of long term side effects, which depend on the treatment you had. Your treatment team keep a close eye on you after your treatment finishes, so that they pick up any problems as early as possible.
It can be difficult to cope with leukaemia and its treatment. But there are medicines to help reduce side effects. There are also people who can support you and help you with the practical and social effects of AML.
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