Acute myeloid leukemia (AML) is a type of blood and bone marrow cancer. It affects the ability of your bone marrow to produce normal-functioning white blood cells (WBCs). The risk of this type of cancer increases with age, and is more common in older adults.

If you have AML, your bone marrow produces an abnormal amount of WBCs that are immature and don’t function properly. These abnormal WBCs eventually build up and replace healthy cells.

The early symptoms of AML can be similar to the flu and may include fever, fatigue, and bone pain.

There are a handful of treatments available for AML, all of which carry a risk of short- and long-term side effects. This article will look at at the side effects associated with AML treatment and how to manage them.

AML treatment typically has two phases. The first phase involves destroying active leukemia cells, while the second phase involves keeping AML in remission.

According to the National Cancer Institute (NCI), there are five main treatments available for AML:

  • Chemotherapy: Chemotherapy is a first-line treatment for most new cases of AML. It involves delivering drugs into a muscle, a vein, or directly into the cerebrospinal fluid, a procedure known as intrathecal chemotherapy. The goal of chemotherapy is to kill leukemia cells in the blood and bone marrow.
  • Radiation therapy for AML: Radiation therapy uses radioactive waves to destroy leukemia cells. External radiation therapy targets cancer cells in a specific area of the body. Total body irradiation delivers radiation to the whole body, and may be used to prepare the body for a stem cell transplant after relapse.
  • Stem cell transplant: A stem cell transplant may be given immediately after chemotherapy or radiation therapy to replenish stem cells in the bone marrow and help your body generate new, cancer-free blood and bone marrow cells. This treatment is typically used to lower your risk of relapse.
  • Targeted therapies: These drugs, such as monoclonal antibodies and protein kinase inhibitors, identify, attack, and disable cancer cells. Since they don’t affect healthy cells, they tend to have fewer side effects than chemotherapy and radiation. Targeted therapies can be used alongside other treatments.
  • Other drug therapies: Other drug therapies may be used to eliminate leukemia cells associated with a subtype of AML called acute promyelocytic leukemia.

When standard treatments for AML aren’t successful, clinical trials are another treatment option.

All cancer treatments carry a risk of side effects. With AML treatment, there are many possible side effects.

The range and severity of your side effects will depend on the type of treatment. In addition, if you receive chemotherapy, side effects will depend on the type of chemotherapy drug you receive.

Other factors that can affect your side effects include your age, sex, and overall health.

With that said, side effects of AML treatment can be intense, according to a 2019 survey of 1,182 AML survivors.

The survey results indicated that:

  • 87% of participants described their short-term side effects as severe
  • 33% described their long-term side effects as severe
  • 11% reported that they didn’t experience any severe side effects

The authors of the study concluded that side effects of treatment for AML constitute a substantial burden for survivors.

Short-term side effects

Short-term side effects occur at the start of treatment. They’re temporary, and usually only last for the duration of the therapy itself.

According to the 2019 survey cited above, the most common and severe short-term side effects of AML treatment included hair loss, experienced by 78% of participants, and fatigue, experienced by 33% of participants.

Other possible short-term side effects of AML treatment include:

Long-term side effects

Side effects of AML treatment can continue or develop after the treatment is finished. Some possible long-term side effects of AML treatment include:

It’s not clear how many AML survivors experience long-term and/or late effects of treatment. In addition, the risks may be greater for certain groups.

For example, a 2021 study of 1,168 adolescent survivors of AML found that 26% experienced endocrine problems later in life, including hypothyroidism, diabetes, and fertility issues.

Cardiovascular problems, such as hypertension and heart diseases, were also common among young adult survivors, affecting around 19%. About 7% of adolescent survivors experienced long-term respiratory issues.

Among adult survivors of AML, weakness and fatigue are common long-term symptoms. A 2018 study followed up with adult AML survivors at 1, 2, and 3 years. The authors reported that after 3 years, 23% still experienced fatigue.

In addition, among older adults with AML, many didn’t fully recover their physical strength and functioning after 3 years.

  • Keep your doctor informed. Talk with your doctor about your side effects. They can prescribe medication for side effects, such as pain, nausea, and anemia. In some instances, a treatment change may be possible.
  • Talk about it. It’s normal to feel worried, anxious, or depressed, even after treatment is over. Most people find that talking about their feelings with a counselor or therapist, a religious leader, or a support group of other cancer survivors helps.
  • Address hair loss. Although hair loss associated with chemotherapy is temporary, it can leave you feeling like you’re not yourself. You have options: try a wig, a headscarf, a hairband, or a hat. It may help to talk with a therapist, support group, or doctor about your hair loss.
  • Care for your skin. Cancer treatment can leave your skin dry and red. Find a good moisturizer and remember to protect your skin with sunscreen when you’re outside.
  • Change your diet. You might experience changes in your appetite during cancer treatment. Try eating smaller, more frequent meals. If you have trouble eating enough food, you may want to consider taking nutritional supplements.
  • Exercise. Incorporating a small amount of physical activity into your day-to-day routine can help you maintain your strength and focus. Physical activity is also beneficial for your mental well-being.
  • Try meditation. Meditation may help you cope with confusion and memory issues, anxiety, nausea, and other side effects of AML treatment.
  • Prioritize sleep and relaxation. While some people find immersing themselves in work or other projects helps them worry less, it’s also important to rest when you need to and get good quality sleep.
  • Talk with a fertility counselor. If you have concerns about your ability to have children once treatment is over, a fertility counselor can provide guidance and support.
  • Ask for help. Your care team, family, and friends are here for you. If you’re struggling with a particular side effect, ask for assistance.
  • Follow your care plan. Even after your treatment is over, you’ll have follow-up appointments, tests, and screenings to attend. Talk with your doctor about what you can expect after treatment is over.

AML is an aggressive cancer that requires intensive treatment. The side effects can be uncomfortable and are likely to temporarily impact your quality of life.

In the past several years, there have been substantial improvements in treatment outcomes. According to the NCI, between 60% and 70% of adults with AML go into remission after appropriate treatment.

In addition, over 25% of adults with AML can expect to survive for 3 or more years after their initial diagnosis.

Treatments for AML include chemotherapy, radiation, and stem cell transplants. Targeted therapies and other drug therapies are also available.

All of these treatments can lead to side effects, some of which can persist in the long term. Some common side effects include hair loss, fatigue, and fertility issues.

Your doctor can help you understand what to expect with treatment, including potential side effects. Remember that you have options.