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Acute myeloid leukaemia - Complications of acute myeloid leukaemia

NHS Choices Medical Reference

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Having a weakened immune system is a common complication of acute leukaemia. The medical term for having a weakened immune system is immunocompromised.

Even if your blood is restored to normal working order, many of the medications that are used to treat acute leukaemia have the side effect of weakening your immune system.

This means you are more vulnerable to developing an infection, and that any infection you have has an increased potential to cause serious complications. You may be advised to take regular doses of antibiotics to prevent infections.

You should avoid contact with anyone who is known to have an infection even if it is a type of infection that you were previously immune to, such as chickenpox or measles. This is because your previous immunity to these conditions may be suppressed.

While it is important to go outside on a regular basis, both for exercise and for your psychological wellbeing, avoid visiting crowded places and using public transport during rush hour.

Report any possible symptoms of an infection immediately to your treatment unit because prompt treatment may be required to prevent serious complications. Complications arising from infection are the leading cause of death in people with acute myeloid leukaemia.

Symptoms of infection include:

  • high temperature (fever) of 38C (100.4F) or above
  • headache
  • aching muscles
  • diarrhoea
  • tiredness

Also ensure that all of your vaccinations are up-to-date. Your GP will be able to advise you about this.

However, you will not be able to have any vaccine that contains activated particles of viruses of bacteria such as:

  • the mumps, measles and rubella (MMR) vaccine
  • the polio vaccine
  • the oral typhoid vaccine
  • the BCG vaccine (used to vaccinate against tuberculosis)
  • the yellow fever vaccine

Bleeding

If you have acute leukaemia, you will bleed and bruise more easily due to the low levels of platelets (clot forming cells) in your blood. Bleeding may also be excessive when it does occur.

People with advanced acute myeloid leukaemia are more vulnerable to excessive bleeding inside their body, and bleeding is the second most common cause of death in people with the condition.

Bleeding can occur:

  • inside the skull (intracranial haemorrhage)
  • inside the lungs (pulmonary haemorrhage)
  • inside the stomach (gastrointestinal haemorrhage)

The symptoms of an intracranial haemorrhage include:

  • severe headache
  • stiff neck
  • vomiting
  • change in mental state, such as confusion

The three most common symptoms of a pulmonary haemorrhage are:

  • coughing up blood from your nose and mouth
  • breathing difficulties
  • a bluish skin tone (cyanosis)

The two most common symptoms of a gastrointestinal haemorrhage are:

  • vomiting blood
  • passing stools (faeces) that are very dark or tar-like

All three types of haemorrhages should be regarded as medical emergencies. Dial 999 to request an ambulance if you suspect that you or your child is experiencing a haemorrhage.

Infertility

Many of the treatments that are used to treat acute leukaemia can cause infertility. Infertility is often temporary, although in some cases it may be permanent.

People who are particularly at risk of becoming infertile are those who have received high doses of chemotherapy and radiotherapy in preparation for bone marrow or stem cell transplantation.

Your treatment team will be able to provide you with a good estimation regarding 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 samples of their sperm stored. Similarly, women can have fertilised embryos stored, which can then be placed back into their womb following treatment.

Read more about infertility.  

Medical Review: May 30, 2012
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