Managing side effects for ALL

Chemotherapy drugs affect fast-growing healthy cells as well as leukaemia cells. This can cause side effects such as nausea, hair loss and fatigue. Other leukaemia treatments, such as targeted therapy and radiation therapy, may also have side effects and your doctor will talk to you about the best way to prevent and manage these. This section focuses on the possible side effects of chemotherapy for acute leukaemia.

Learn more about:

• Overview
• Effects on the blood
  • Easy bruising or heavy bleeding
  • Increased risk of infections 
  • Fatigue
• Taking care with infections during chemotherapy
• Other common side effects

Overview

Most side effects are short term, but some may be permanent. Side effects tend to gradually improve once treatment stops and the normal, healthy cells recover. Side effects can usually be managed.

Some side effects from chemotherapy may not show up for months or years. These are called late effects. Before treatment starts, talk to your doctor about whether you are at risk of developing late effects from your treatment and what you can do to help prevent them. Once treatment has finished, it is important to see your GP for regular health checks.

Tell your treatment team about your side effects or anything unusual you experience. Check with your doctor before using ibuprofen, aspirin or other medicines, including herbal medicines. These may affect how the chemotherapy works and may make side effects worse.

Effects on the blood

Easy bruising or heavy bleeding

Chemotherapy can lower the number of platelets in your blood. This is called thrombocytopenia, and it means you will bruise and bleed more easily from cuts and scrapes. You may also have nosebleeds or bleeding gums. If you usually have monthly periods (menstruate), you will be given drugs to stop periods and prevent blood loss while platelet counts are low. Your doctor may recommend you have a platelet transfusion to help raise your platelet count.

Increased risk of infections

The combination of chemotherapy drugs, as well as the leukaemia itself, will lower your levels of the white blood cells called neutrophils. This is known as neutropenia and it can make it harder for your body to fight infections. Viruses such as colds, flu and COVID-19 may be easier to catch and harder to shake off, and scratches or cuts may get infected more easily.

To speed up the production of new white blood cells, your doctor may give you injections of a growth factor drug called granulocyte-colony stimulating factor (G-CSF). There are several ways you can reduce your risk of getting an infection.

Fatigue

Your red blood cell level may drop (anaemia), causing you to feel tired and breathless. This can be treated with blood transfusions.

Some people feel fatigued for weeks or months after leukaemia treatment, even once their blood count returns to normal. To manage this, plan activities for the time of day you feel most energetic. Exercise can reduce fatigue and improve mood. Talk to your health care team for more ways to manage fatigue.

For more on this see Exercise for people living with cancer or listen to our podcasts on Managing Cancer Fatigue and Sleep and Cancer.

Taking care with infections during chemotherapy

Here are some tips to reduce your risk of infection during chemotherapy, and advice on when to seek medical help.

→ READ MORE: Other common side effects

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