Complications of acute myeloid leukaemia

If you have acute myeloid leukaemia (AML), you may experience a number of complications. These can be caused by the condition itself, although they can also occur as a side effect of treatment.

Some of the main complications associated with AML are outlined below.

Weakened immune system

Having a weakened immune system being immunocompromised is a common complication of AML.

Even if your blood is restored to normal working order with treatment, many of the medications that are used to treatAML can temporarily weaken your immune system.

This means you're more vulnerable to developing an infection, and any infection you develop could be more serious than usual. Complications arising from infection are the leading cause of death in people with AML. However, if treated early, nearly all infections respond to appropriate treatment.

Therefore, you may be advised to:

• take regular doses of Penicillin to prevent bacterial infections
• maintain good personal and dental hygiene
• avoid contact with anyone who'sknown to have an infection even if it's a type of infection that you were previously immune to, such as chickenpox or measles
• check with your GP to ensure that all of your vaccinations are up to date, althoughyou won't be able to have any vaccine that contains "live" viruses or bacteria, such as the shingles vaccine and MMR vaccine (against measles, mumps and rubella)

Report any possible symptoms of an infectionto yourtreatment unit immediately because prompt treatment may be needed to prevent complications.

Symptoms of an infection caninclude:

• a high temperature (fever)
• a headache
• aching muscles
• diarrhoea
• tiredness

Bleeding

If you have AML, you'll bleed and bruise more easily due to the low levels of platelets (clot-forming cells) in your blood. Bleeding may also be excessive.

People with advanced AML are morevulnerable to excessive bleeding inside their body, which is the second most common cause of death in people with the condition.

Serious bleeding can occur:

• insidethe skull (intracranial haemorrhage) causing symptoms such as asevere headache, stiff neck, vomiting and confusion
• inside the lungs (pulmonary haemorrhage) causingsymptoms such as coughing up blood ,breathing difficulties and abluish skin tone ( cyanosis )
• inside the stomach (gastrointestinal haemorrhage) causing symptoms such as vomiting blood andpassing stools (faeces) that are very dark or tar-like in colour

All these types of haemorrhage should be regarded as medical emergencies. Dial 999 immediately and ask for an ambulance if you think a haemorrhage is occurring.

Infertility

Many of the treatments that are used to treat AML can cause infertility .This is often temporary, but in some cases can be permanent.

People particularly at risk of permanent infertility are those who have received high doses of chemotherapy and radiotherapy in preparation for a bone marrow or stem cell transplant .

Your treatment team can give a good estimation of the risk of infertility in your specific circumstances.

It may be possible to guard against any risk of infertility before you begin your treatment. For example, men can have their sperm samples stored. Similarly, women can have eggs orfertilised embryos stored, which can then be placed back into their womb, following treatment.

However, as AML is an aggressive condition that develops rapidly, there may not always be time to do this before treatment needs to start.