Side effects of treatments in AML

Patients report side effects at each follow-up visit. Assembling this information often falls to nursing professionals who spend more time with patients. However, this is extremely important. For example, damage to heart muscle from anthracyclines can be minimised by adjusting the dose or prescribing a different drug.

Targeted drugs have specific side effects according to their mechanism of action (Table 4). They often cause less side effects than chemotherapy because they target specific components of the leukaemia cell.

Table 4          Specific side effects for drugs for AML

Drug type Drug Specific side effect
Targeted drug Midostaurin Oedema of hands, feet and ankles


  Gilteritinib Abnormal liver tests

Heart rhythm disturbances

Seizures or confusion

Differentiation syndrome1

  Gemtuzumab ozogamicin Swelling and sores in the mouth

Allergic reactions on infusion

Disturbances in heart rhythm

Serious/life-threatening infections

Severe liver damage, including veno-occlusive disease (blockage of veins in the liver)

  Glasdegib Muscle spasms
  Venetoclax Pneumonia and other serious infections

Tumour lysis syndrome2

Anthracycline Daunorubicin Doxorubicin Heart rhythm disturbances (short-term)

Heart muscle damage (long-term)

1      Differentiation syndrome is a rare but serious side effect. This syndrome includes fever, fluid build-up in the lungs and around the heart, low blood pressure and liver or kidney damage. It is caused when the patient has a large number of leukaemia cells that release cytokines (immune substances). Stopping gilteritinib for a while and treatment with steroids can help improve symptoms

2     Tumour lysis syndrome occurs in patients who have large numbers of leukaemia cells at the start of treatment. As they are rapidly destroyed, these leukaemia cells release uric acid, potassium, and phosphorus in the blood faster than the kidney can excrete them. These raised levels of electrolytes can cause damage to the kidneys, heart or liver