Therapy for acute lymphoblastic leukemia (ALL) can produce side effects. For most patients, treatment side effects are temporary and go away once therapy ends. For other patients, side effects can be severe, sometimes requiring hospitalization.
Before you start treatment, talk with your doctor about potential side effects. Drugs and other therapies can prevent or manage many side effects. Many treatment side effects go away or become less noticeable over time.
Common Side Effects
Chemotherapy drugs are the main culprits when it comes to causing unwanted side effects. These drugs can kill cancer cells, but they can damage normal cells, too. The lining of the mouth, throat, stomach and intestines are particularly vulnerable to damage.
The side effects you may experience depend on:
- The intensity of chemotherapy
- The drugs used during therapy
- Your overall health and whether you have any chronic health conditions like diabetes or kidney disease
Side effects common to ALL and its treatment, especially chemotherapy and stem cell transplantation, include:
- Low blood cell counts. ALL can cause a decrease in normal blood cell production. Chemotherapy is toxic to both normal blood cells and ALL cells, making the number of your healthy cells decrease.
- Infection. Your infection risk increases during chemotherapy when your body doesn't produce enough white cells to keep your immune system working properly.
- Graft versus host disease. If you undergo an allogeneic stem cell transplantation, you're at risk of developing graft versus host disease (GVHD). GVHD develops when the donor's immune cells mistakenly attack the patient's normal cells. GVHD can be mild, moderate or severe - even life threatening.
- Tumor Lysis Syndrome (TLS). TLS is characterized by metabolic abnormalities caused by the sudden release of the cellular contents of dying cells into the bloodstream, which is induced by chemotherapy. If untreated, TLS can lead to heart arrhythmias, seizures, loss of muscle control, acute kidney failure and even death. Patients are constantly monitored for the development of this condition and are given preventive therapy. Patients who have very high white blood cell counts before induction therapy are at an especially high risk for developing TLS.
- In patients who have received corticosteroids such as prednisone and dexamethasone as part of their treatment:
- Hyperglycemia and steroid-induced diabetes. Patients should be monitored for glucose control.
- Gastric ulcers. Use of proton-pump inhibitor drugs to reduce stomach acid is recommended during steroid therapy to reduce these risks.
The following side effects are also common. Click here to read more about these side effects.
- Mouth ulcers (canker sores)
- Temporary hair loss
- Itchy skin
- Nausea and vomiting
- Loss of appetite
Long-Term and Late Effects of Treatment
For some patients, side effects may last well after they finish treatment. To read more about lingering side effects, see The Leukemia & Lymphoma Society’s free publications:
- Long-Term and Late Effects of Treatment in Adults
- Long-Term and Late Effects of Treatment for Childhood Leukemia and Lymphoma Facts.
- Managing Side Effects
- Integrative Medicine and Complementary and Alternative Therapies
- Download lists of questions to ask your doctor
- Download or order The Leukemia & Lymphoma Society’s free booklet, Understanding Side Effects of Drug Therapy