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Side Effects

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

The side effects you may experience depend on:

  • The intensity of chemotherapy
  • The drugs used during therapy
  • 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 healthy cells decrease.
  • Infection. The infection risk increases during chemotherapy when the body doesn't produce enough white cells to keep the immune system working properly.
  • Pain. Patients may experience bone pain due to leukemia cells in the bone marrow. Some chemotherapy medications may cause peripheral neuropathy, a nerve problem that can cause pain, numbness and tingling in the hands and feet. 
  • Graft versus host disease. Patients who undergo an allogeneic stem cell transplantation are 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 with leukemia are constantly monitored for the development of TLS and are given drugs, such as allopurinol (Zyloprim®) or rasburicase (Elitek®), to prevent or lessen the effects of this condition. 
  • 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.
    • Stomach 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 sores
  • Diarrhea
  • Hair loss
  • Rashes
  • Nausea and vomiting
  • Headaches
  • Loss of appetite
  • Fatigue
  • Neuropathy-numbness, tingling or muscle weakness (usually in the hands or feet) 

Long-Term and Late Effects of Treatment

For some patients, side effects may last or appear well after they finish treatment  To read more about lingering side effects, see The Leukemia & Lymphoma Society’s free publication, Long-Term and Late Effects of Treatment in Adults

For information about the drugs listed on this page, visit Drug Listings.

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