White Blood Cells (WBC) are the infection fighting cells within our body. The exact causes of acute myeloid leukaemia are unknown and in most cases it is unclear why leukaemia has developed. Research into possible causes is going on all the time.
Large doses of radiation may increase the risk of leukaemia. People exposed to high levels of radiation, such as nuclear industry accidents, have a higher risk of developing leukaemia than people who have not been exposed to radiation.
Smoking increases the risk of developing AML. It is thought that this may be due to the concentrated levels of benzene in cigarette smoke. In very rare cases, AML may occur after long-term exposure to benzene (and possibly other solvents) used in industry.
Rarely, some anti-cancer treatments such as chemotherapy or radiotherapy can cause leukaemia to develop some years later. The risk is increased when certain types of chemotherapy drugs are combined with radiotherapy. When leukaemia develops because of previous anti-cancer treatment this is called secondary leukaemia or treatment-related leukaemia.
People with certain blood disorders, such as myelodysplasia, or some genetic disorders, including Down's syndrome, have a higher risk of developing AML. It is not caused by an inherited faulty gene.
Acute myeloid leukaemia isn't infectious and can’t be passed on to other people.
Symptoms of Acute Myeloid Leukaemia
Most of the symptoms of acute myeloid leukaemia are due to the effects of the leukaemia cells in the bone marrow, which leave it unable to produce enough normal blood cells.
The main symptoms are:
- Looking pale, feeling tired and breathless, which is due to anaemia caused by a lack of red blood cells.
- Having more infections than usual, because of a lack of white blood cells.
- Unusual bleeding, caused by too few platelets. This may include bruising easily without any obvious cause, bleeding gums, frequent nosebleeds, and heavy periods in women. Some people have a rash of tiny, flat red spots on the skin of the legs or in the mouth. These are called petechiae.
- Feeling generally unwell and run down.
- Having a fever and sweats. This may be due to an infection or to the leukaemia itself.
Other, less common, symptoms may be caused by a build up of leukaemia cells in a particular area of the body, such as:
- Aching bones, caused by pressure from a build up of immature cells in the bone marrow.
- Raised bluish-purple areas under the skin - due to leukaemia cells in the skin.
- Swollen gums, caused by leukaemia cells in the gums
How Chemotherapy is given
The chemotherapy drugs are usually given by drip or injection through a thin, flexible plastic tube. The tube is inserted under the skin and into a vein near the collarbone (central line or Hickman® line), or passed through a vein in the arm (PICC line). Your doctor or nurse will explain more about this to you, and there is more information in this section.
Chemotherapy is usually given as several sessions (cycles) of treatment. Each session lasts for 5-10 days and is followed by a rest period of three to four weeks. This rest period allows your body to recover from the side effects of the treatment. Most people have four or five cycles of chemotherapy. The complete course of treatment can last about six months.
Side Effects
Unfortunately, Chemotherapy can cause alot of unpleasant side effects. Some are shown below:Chemotherapy affects different people in different ways. Some find they are able to lead a fairly normal life during their treatment, but many find they become very tired and have to take things much more slowly. Do as much as you feel like and try not to overdo it.
Lowered resistance to infection
While the chemotherapy drugs are acting on the leukaemia cells in your body, they also reduce the number of normal cells in your blood for a while. When white blood cells are in short supply, you are more likely to get an infection. During chemotherapy your blood will be tested regularly. You will probably be given tablets or other medicines to reduce the risk of certain types of infection.
If you get an infection, you will be treated for it straight away. Most infections are caused by bacteria, fungi or viruses already present in your own body, or in the environment. These do not normally cause infection, but when your immunity is low they are more likely to cause a problem.
It is best to avoid coming into contact with people who may have an infection. You may also be advised to be careful about what you eat, in order to guard against the risk of infection from raw, undercooked or contaminated food. The hospital will give you information on how to prepare foods and which foods to avoid.
If your temperature goes above 37.5ºC (100ºF) or you suddenly feel unwell, even with a normal temperature, contact your doctor or nurse at the hospital straight away.
Anaemia
If the level of red blood cells in your blood is low you may become very tired and lethargic. You may also become breathless. These are all symptoms of anaemia - a lack of red blood cells in the blood.
Anaemia can be treated by blood transfusions.
Increased risk of bruising and bleeding
Platelets help your blood to clot. When you have leukaemia, the number of platelets in your blood is lower than normal, and chemotherapy may temporarily reduce the numbers even more. This means that you may bruise very easily, and may bleed heavily from even minor cuts and grazes.
You may need to have a transfusion of platelets before your chemotherapy begins, and at times during your treatment, to increase the number of platelets.
If you develop any unexplained bruising or bleeding, contact the hospital immediately.
Tiredness (fatigue)
This is a very common side effect of chemotherapy. The fatigue may be caused by anaemia, but may also be due to chemotherapy, even if your blood count is normal. You may be especially aware of this when you are at home between cycles of chemotherapy, and for a few months after the treatment has finished.
Changes to the way that your heart works
Some of the drugs used to treat acute myeloid leukaemia may affect the heart muscle. The doses of the chemotherapy drugs are carefully monitored, and heart tests may be done from time to time to check your heart function.
Sore mouth
Some chemotherapy drugs can make your mouth sore and cause mouth ulcers. Regular mouthwashes are important and the nurses will show you how to use these properly. If you don't feel like eating during treatment, you could try replacing some meals with nutritious drinks or a soft diet. A nurse or dietitian at the hospital can give you advice about how to eat well during your chemotherapy if your mouth is sore.
Feeling sick
Some of the drugs used to treat acute myeloid leukaemia may make you feel sick and may sometimes cause vomiting. There are now very effective anti-sickness drugs (anti-emetics) to prevent or greatly reduce nausea and vomiting. Your doctor will prescribe these for you. If you still feel sick, despite the anti-emetics, let your doctor or nurse know so that they can change them for other drugs, which may be more effective.
Hair loss
Hair loss is another common side effect of these drugs. This can be very upsetting. If your hair falls out it should start to grow back over a period of 3-6 months once the treatment ends. There are many ways of covering up, including, wigs, hats or scarves. You may be entitled to a free wig from the NHS and your doctor or one of the nurses on the ward can arrange for a wig specialist to visit you.
Pentamidine
Pentamidine isethionate is an antimicrobial medication primarily given for prevention and treatment of Pneumocystis pneumonia (PCP) caused by Pneumocystis jirovecii, also formerly known as Pneumocystis carinii pneumonia (PCP), a severe interstitial type of pneumonia often seen in patients with HIV infection. PCP is considered an 'opportunistic infection', endangering only immunodeficient patients such as those with HIV/AIDS/CANCER.
Opportunistic Infection
Opportunistic infections are infections caused by pathogens that usually do not cause disease in a healthy immune system. A compromised immune system, however, presents an "opportunity" for the pathogen to infect.
