Side effects of treatment
Intravenous chemotherapy has well established short term side effects that include:
- Immunosuppression (lowered resistance to infection) is particularly severe in those undergoing AML treatment
- Fatigue
- Hair loss
- Nausea and vomiting
- Diarrhoea
- Weight loss
CNS directed therapy in the form of intrathecal chemotherapy has few side effects as it has been significantly reduced. However, those with CNS disease who require repeated intrathecal therapy have a higher incidence of side effects and those with additional radiotherapy the most severe effects. Side effects may include fits and later learning difficulties. Those who have undergone radiotherapy may suffer from the somnolence syndrome (severe tiredness, the child sleeps all the time) or the acute cerebellar syndrome. Combined intrathecal and CNS radiotherapy may lead to severe ongoing neurological problems including learning difficulties that persist in to adult life.
Biological therapy
The following drugs may be mentioned in the medical evidence. In general their side effects are minimal:
- gemtuzumab ozogamicin (GMTZ) - the most serious adverse effects are liver toxicity and bone marrow suppression.
- CEP-701 – lestaurinib – biological therapy, side effects are diarrhoea and vomiting.
Long term side effects of chemotherapy treatment
Side effects following treatment of AML more than 10 years ago were reported in an American study:
- Growth abnormalities (mainly reduced height) 51%
- Neurocognitive abnormalities – 30% includes one of the following: academic difficulties, hearing loss, speech problems or epilepsy
- Endocrine abnormalities – e.g. hypothyroidism, growth hormone deficiency, delayed puberty, infertility
- Cataracts – 12%
- Cardiac abnormalities 8%
- Second cancers 2 -10%
