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Side effects of chemotherapy for acute myeloid leukaemia (AML)

The chemotherapy drugs for acute myeloid leukaemia affect people in different ways. You will have some of the side effects listed here. It isn't possible to tell how you will react until you have a particular drug.

What is chemotherapy?

Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. The drugs circulate throughout the body in the bloodstream.

Possible side effects

All the drugs used to treat AML make your blood counts fall. 

Diagram of three different types of blood cell

Red blood cells

You might need blood transfusions to top up your red blood cells.

White blood cells

When your white blood cells fall you are at risk of infection. Some infections can be life threatening. 

Platelets

You are at risk of bleeding or bruising when your platelets are low. You can have platelet transfusions to top up your platelets.

Signs of an infection include headaches, aching muscles, a cough, a sore throat, pain passing urine, or feeling cold and shivery.

Contact your advice line or doctor straight away if you have any of these signs, or your temperature goes above 37.5C or below 36C. Severe infections can be life threatening.

Chemotherapy reduces the number of white blood cells in the blood. This increases your risk of infections. White blood cells help fight infections.

When the level is very low it is called neutropenia (pronounced new-troh-pee-nee-ah).

You have antibiotics if you develop an infection. You might have them as tablets or as injections into the bloodstream (intravenously). To have them into your bloodstream you need to go into hospital.

Feeling or being sick can be severe. It can start a few hours after treatment and last for a few days. Anti sickness injections and tablets can control it. Tell your doctor or nurse if you feel sick. You may need to try different anti sickness medicines to find one that works.

Contact your doctor or nurse straight away if you’ve been sick more than once in a day.

Tips

  • Avoid eating or preparing food when you feel sick.
  • Avoid fried foods, fatty foods or foods with a strong smell.
  • Drink plenty of liquid to stop you from getting dehydrated.
  • Relaxation techniques help control sickness for some people.
  • Ginger can help – try it as crystallised stem ginger, ginger tea or ginger ale.
  • Fizzy drinks help some people when they are feeling sick.

You could lose all your hair. This includes your eyelashes, eyebrows, underarm, leg and sometimes pubic hair. It usually starts gradually within 2 to 3 weeks after treatment begins.

Your hair will grow back once your chemotherapy treatment has finished. This can take several months and your hair is likely to be softer. It can also grow back a different colour or be curlier than before.

Tips

  • Ask about getting a wig before you start treatment so you can match the colour and texture of your real hair.
  • You could choose a wig for a whole new look.
  • Think about having your hair cut short before your treatment starts.
  • Some people shave their hair off completely so they don't have to cope with their hair falling out.
  • Wear a hairnet at night so you won't wake up with hair all over your pillow.

Your mouth might become sore about 5 to 10 days after you start treatment. It usually clears up gradually 3 to 4 weeks after your treatment ends.

Your doctor or nurse can give you mouthwashes to help prevent infection. You have to use these regularly to get the most protection.

Tell your doctor or nurse straight away if your mouth is really sore. They can help to reduce the discomfort. Some people need strong painkillers to help control mouth pain so they can eat and drink.

Tips

  • Clean your mouth and teeth gently every morning and evening and after each meal.
  • Use mouthwashes as advised by your doctor or nurse. Let them know if the mouthwash stings. They can tell you to stop using it or dilute it with water.
  • Use dental floss daily but be gentle so that you don't harm your gums, and don't floss if you have very low platelets.
  • Avoid neat spirits, tobacco, hot spices, garlic, onion, vinegar and salty food.
  • Moisten meals with gravies and sauces to make swallowing easier.
  • Avoid acidic fruits such as oranges, grapefruit or lemons.

Talk to your doctor before starting treatment if you think you may want to have a baby in the future.

Men

You may be able to store sperm before starting treatment.

It can take a few months or sometimes years for fertility to return to normal. You can have sperm counts to check your fertility when your treatment is over. Ask your doctor about it.

Women

Chemotherapy can cause an early menopause. This stops you from being able to become pregnant in the future. Talk to your doctor about this before your treatment. It’s sometimes possible to store eggs or embryos before treatment.

When cancer drugs kill the cancer cells, the body breaks down the dead cells. Chemicals in the cells are released into your blood. So the normal balance of chemicals circulating in your blood suddenly changes.

Chemicals such as potassium, sodium, phosphates and urea have to be kept within very tight limits in your bloodstream to keep you healthy. Abnormal levels of these chemicals can upset your heart rhythm and the way your kidneys work.

If you are at risk of tumour lysis syndrome you might have:

  • extra fluids before your treatment
  • medicines called rasbirucase or allopurinol to help prevent it

More information about this treatment

We haven't listed all the very rare side effects of this treatment. For further information see the electronic Medicines Compendium (eMC) website.

You can report any side effect you have that isn’t listed here to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

Information and help