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The leukaemia is termed ‘acute’ because it develops quickly. When a patient develops AML, too many white blood cells are produced within their bone marrow. These cells, which are known as blast cells, are released into the blood before they have developed properly so they do not behave in the way healthy white blood cells do.
The over-production of blast cells in the bone marrow also means that it is unable to produce the other types of blood cells that are found in the blood. There are various types of AML depending on which type of cell is affected and how well developed the cell is. They are all treated in the same way except for one type called acute promyelocytic leukaemia (APL).
The information in the following pages relates to adults with AML.
The signs and symptoms of AML vary from patient to patient. You may experience the following:
- a feeling of exhaustion
- pale skin
- increased bruising of the skin
- fever and infection
- swollen glands
- limb pains.
Many of these symptoms are caused by the increased numbers of abnormal white blood cells and a decrease in the amount of normal blood cells in the blood stream and the bone marrow.
Feeling tired and looking pale is a sign of a lack of red blood cells (anaemia). Bruising of the skin is a sign of a lack of blood cells called platelets.
A series of tests or investigations will be done to confirm or rule out a diagnosis of acute myeloid leukaemia (AML) and to check on your general health. These tests may include:
Bone marrow sample
In order to confirm what type of leukaemia you have and to plan your treatment, it is necessary to examine a small sample of bone marrow. This is normally taken from the hip bone and is examined to determine whether any blast cells are present.
The process is conducted under local anaesthetic and takes five to ten minutes. It is not painful, although some patients find it uncomfortable. The procedure will be explained to you before it is carried out and you will be able to ask any questions or raised any concerns you might have.
Blood tests will be taken throughout your treatment to monitor how you are responding and how effective your treatment is.
Your treatment for acute myeloid leukaemia (AML) will be planned individually for you. It will involve chemotherapy and perhaps stem cell transplant. Do not be concerned if you talk to other people who are receiving similar, but different, treatment.
Chemotherapy means treatment with anti-cancer drugs, which destroy cells by damaging them so that they can't divide and grow. Normal cells recover quickly, the leukaemia cells do not. As the drugs circulate in the blood, they reach leukaemia cells all over the body.
The effects and side effects of the regime chosen for you will be explained by your doctor or clinical nurse specialist. Please ask any questions you have about the drugs and why they have been chosen.
You will need to be admitted to hospital for a period of three to four weeks Chemotherapy is normally given at intervals over several weeks or months. During this time you will have regular blood tests and bone marrow samples to monitor your progress.
Stem cell transplant
You may be offered high-dose chemotherapy which is intensive treatment. In addition to destroying leukaemia cells, this treatment will also destroy healthy bone marrow cells. A peripheral stem cell transplant will give you a source of healthy bone marrow that will produce normal white blood cells.
If a transplant forms part of your treatment, your consultant and clinical nurse specialist will explain the procedure in more detail and discuss the benefits and side effects with you.
Having acute myeloid leukaemia (AML) and being treated for it will have an effect on your life.
Treatment for AML, as with other leukaemia, is very effective and can control the condition and the symptoms you experience for many years.
After your treatment is finished you will continue to be monitored with regular checkups and blood tests. If you notice new symptoms or have any concerns about your health between appointments, contact your doctor.
Sex and fertility
Some chemotherapy drugs can damage the ovary or testes, leading to an increased risk of infertility and, in women, early menopause.
Chemotherapy may affect sexual organs or functions in various ways. You may experience changes in your desires or desired level of sexual activity or you may notice no difference. Loss of libido (sex drive) is not uncommon in both women and men. However, chemotherapy in itself doesn’t usually affect sexual performance or cause impotence.
During your treatment you may start to feel tired and listless. This may be general fatigue or it may be that you become tired more easily after normal activities. This is quite normal and usually occurs with leukaemia and its treatments.
Do talk about how you are feeling with your consultant or clinical nurse specialist. They will be able to suggest ways of conserving your energy or may be able to treat the causes of your tiredness, such as not being able to sleep or anaemia.
If you are at home, try to plan your day so that light activities are spaced between more energetic activities. Do get enough rest and only do what you feel you can cope with.
People will often be willing to lend their support. If you get tired easily, limit your activities and conserve your energy for the things that mean the most to you. Ask your family and friends to help with household chores.