Acute myeloid leukemia (AML) treatment side effects can include hair loss, fatigue, and nausea. However, these will vary depending on the type of treatment a person receives and how their cancer responds to it.

AML is an aggressive form of blood cancer. Treatment can involve intensive therapies to reduce the growth of cancerous cells, such as chemotherapy, targeted therapy, and stem cell transplantation.

Intensive treatments can be more likely to cause side effects than less intense approaches, but not everyone will experience every side effect.

This article explores potential AML treatment side effects, who is at risk, and what strategies can help people manage them or reduce their impact.

An older woman sitting in a chair in hospital for AML treatment.Share on Pinterest
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AML treatment can lead to a range of short-term side effects. Depending on the treatment, these may include:

  • Digestive symptoms: Many AML treatments, including chemotherapy, can cause nausea, vomiting, or changes in bowel movements.
  • Hair loss: Certain chemotherapy drugs can lead to hair loss. The hair usually regrows once the chemotherapy ends.
  • Fatigue: AML treatment can cause significant tiredness and fatigue, which may make it challenging to perform daily tasks. A person may also experience mental fatigue, which can affect their ability to think or concentrate.
  • Changes to taste and smell: Chemotherapy and radiation therapy can cause changes in a person’s senses of taste and smell. These changes are typically temporary but can last for several months.
  • Bone marrow suppression: AML treatments suppress the bone marrow’s ability to produce healthy blood cells. During intensive treatment, this often results in very low blood counts. A person may develop anemia due to low red blood cells, an increased risk of bleeding due to low platelets, and increased susceptibility to infections due to low white blood cells.

The primary goal of AML treatment is remission, a state in which doctors cannot detect any cancerous cells. The benefits of undergoing treatment usually outweigh the risks because AML progresses rapidly if a person does not receive treatment.

However, some people experience long-term side effects after AML treatment. They may begin soon after treatment or may not become apparent for some time. They can last months or years.

These longer lasting effects may include:

  • Fatigue: Some people experience persistent fatigue, especially after intensive or high dose treatments. This may last a long time.
  • Infertility: Some AML treatments, particularly high dose chemotherapy and radiation therapy, can affect a person’s fertility. Impaired sperm production can be temporary, but changes to the ovaries can be permanent.
  • Osteoporosis: Osteoporosis occurs when bones lose density, becoming weaker. Any cancer treatment that lowers estrogen levels can increase the risk of osteoporosis.
  • Hearing changes: Chemotherapy drugs can lead to long-term hearing loss or hearing changes. A 2017 study found that cisplatin can remain in the inner ear after treatment, leading to conditions such as tinnitus. Higher doses and more frequent rounds of chemotherapy may increase the risk of this complication.
  • Cardiac and pulmonary complications: Chemotherapy drugs can have long-term effects on the heart and lungs, including pneumonia, heart arrhythmias, congestive heart failure, and coronary artery disease.
  • Other cancers: Chemotherapy can increase a person’s risk of having a second type of cancer.

This is not a comprehensive list. People can speak with their doctor for more information about the specific risks of their treatments.

Anyone can experience side effects during AML treatment, but certain factors can make them more likely. These factors include:

  • Age: Older individuals tend to have a higher risk of experiencing side effects during chemotherapy. This may be due to reduced organ function, preexisting medical conditions, and decreased tolerance to treatment.
  • Sex: A 2022 study found that females had a 34% greater chance of experiencing severe side effects from several cancer treatments than males. The differences between sexes were especially pronounced in those receiving immunotherapy. Scientists are still researching the cause of this disparity.
  • Genetic variations: Specific genetic variations influence how a person metabolizes and responds to specific drugs, potentially affecting the risk and severity of side effects.
  • Treatment type: Chemotherapy, targeted therapy, radiation therapy, and stem cell transplantation have specific side effect profiles. The type, duration, intensity, and combination of these treatments can influence the risk and severity of side effects.
  • Overall health: Older age and preexisting medical conditions may increase the risk of complications during AML treatment. This may mean that intensive treatment is unsafe.

The duration of AML treatment depends on a person’s health, the type of AML they have, and their treatment response.

If a person is well enough, a doctor may recommend intensive treatment, which has two stages: induction therapy and consolidation therapy.

Induction therapy aims to rid the body of leukemia cells and takes around 1 month.

Consolidation therapy aims to improve the treatment response and reduce the chances that AML will return. This can take up to 6 months.

If a person is not well enough for intensive treatment, they may be able to have non-intensive therapies such as low dose chemotherapy. This approach aims to manage the AML as much as possible for as long as possible. As a result, a person may have ongoing treatment for many months.

AML treatment side effects can be unpleasant, but there are ways to reduce them. A doctor may recommend:

  • Treatment changes: Doctors may change the treatment plan to reduce or eliminate specific side effects. This may involve adjusting medication dosages, changing the frequency or duration of treatment cycles, or exploring complementary therapies.
  • Medications: Antinausea medications such as ondansetron can help control nausea and vomiting. Pain medications can relieve treatment-related discomfort. Medications to stimulate blood cell production, such as growth factors, can counteract bone marrow suppression.
  • Supportive care: This may include hydration and nutritional support, antibiotics to manage infections, and strategies to support emotional well-being, such as talk therapy or support groups.

If a person is undergoing intensive treatment, they will typically spend some time in a hospital due to the risk of serious side effects. This is particularly true during the induction phase.

Once they are home, they can try the following strategies to cope with AML treatment side effects:

  • Rest: Prioritize rest by getting enough sleep, having naps, or switching from tiring activities to more restful ones. People may benefit from changing or reducing their working hours.
  • Movement: Gentle exercise may help reduce fatigue both during and after cancer treatment. People can try walking, stretching, gentle yoga, or tai chi.
  • Hydration: Stay hydrated by drinking enough water. If a person feels nauseated, they can try taking small sips of water throughout the day. Electrolyte replacement may be necessary if they experience vomiting or diarrhea.
  • Nutrition: Get enough calories and nutrients each day. If a person loses their appetite, eating multiple smaller meals or snacking regularly may be easier than eating three bigger meals.
  • Hygiene: Taking precautions, such as practicing good hand hygiene and avoiding exposure to sick individuals, can help reduce the risk of infections.
  • Emotional and mental well-being: Engage in self-care activities that promote relaxation and stress reduction, such as meditation, deep breathing exercises, or hobbies.

AML treatment side effects can include nausea, hair loss, fatigue, and changes in cognition. However, the side effects will vary, depending on a person’s situation and response to treatment.

AML treatment can be intensive, in which case side effects are more likely. But doctors can recommend ways to reduce or manage these effects, such as by taking additional medication or changing a person’s treatment plan.

A person may stay in a hospital for some of their treatment so doctors can monitor them for serious side effects. When a person gets home, self-care measures such as rest, hydration, and good hygiene practices are essential.