Care and mobility considerations
Acute Myeloid Leukaemia (AML)
Treatment and recovery for those who successfully undergo combination chemotherapy or bone marrow transplant is likely to take 1 year to 2 years. Needs are likely, related to both treatment and the disease. During this period they are likely to have periods of being immunosuppressed and be unable to go out in public. Episodes of severe fatigue may endure for many months related to chemotherapy treatment and anaemia.
Mobility
Severe fatigue and reduced exercise tolerance related to any of the following may reduce the ability to walk:
- Chemotherapy treatment
- Anaemia
- Side effects of drugs used – effects on lungs (pulmonary oedema), spinal cord, brain (cerebellum) and nerves
People who are immunosuppressed may be advised to avoid public places.
Care
Severe fatigue may make activities of daily living difficult. Help with activities of daily living from someone else may be required because of pain, fatigue or dizziness.
Acute Lymphoblastic Leukaemia (ALL)
Treatment and recovery for those who successfully undergo combination chemotherapy or bone marrow transplant is likely to take 1 year to 2 years. Needs are likely, related to both treatment and the disease. During this period they are likely to have periods of being immunosuppressed and be unable to go out in public. Episodes of severe fatigue may endure for many months related to chemotherapy treatment and anaemia.
Mobility
Severe fatigue and reduced exercise tolerance related to any of the following may reduce the ability to walk:
- Chemotherapy treatment
- Anaemia
- Side effects of drugs used – effects on lungs (pulmonary oedema), spinal cord, brain (cerebellum) and nerves
People who are immunosuppressed may be advised to avoid public places.
Care
Severe fatigue may make activities of daily living difficult. Help with activities of daily living from someone else may be required because of pain, fatigue or dizziness.
Chronic Myeloid Leukaemia (CML)
Treatments for chronic and accelerated phase CML are the same, people with accelerated phase CML are more likely to have symptoms but these are likely to resolve with treatment when a person goes into remission. Needs are unlikely to be identified because of either the disease or its treatment. The exception to this is when treatment includes a bone marrow or stem cell transplant. You should follow guidance on care and mobility considerations for bone marrow and stem cell transplant if this treatment is being given. The treatment of chronic CML has improved a lot over the last few years and long term survival with treatment is common. About half of people who have bone marrow or stem cell transplant for chronic CML are cured of their disease and many others achieve long term survival on Imatinib. Progressive disease and needs are most likely in those whose disease has not responded to Imatinib and who are unable to have a bone or stem cell transplant for some reason.
Chronic Lymphocytic Leukaemia (CLL)
Most people with CLL will be elderly with slowly progressive disease, many will not require treatment or their disease will be controlled with a course of oral Chlorambucil (an anticancer drug). Typically no disabling effects of disease or treatment are present. Anyone who has recurrent disease or has combination chemotherapy or bone marrow or stem cell transplant most likely will have disabling effects related to treatment -particularly fatigue. If needs are identified awards should be time limited to coincide with recovery from treatment. Survival will depend on the stage of the disease at diagnosis and number of recurrences. People with stage A CLL generally live on average for at least 10 years. People with advanced disease (stage C) generally live on average 2-3 years. People having aggressive treatment or who have advanced disease are more likely to have needs and less likely to return to health after treatment. Longer term or indefinite awards should be considered if disease is described as advanced in the medical evidence or disease has recurred more than once.
Click the link for details of:
Amended February 2009
