Different people have different responses to their treatment. Even if two patients are having the same treatment, they may have a different experience. You might not get all, or even any, of these side effects – try to bear this in mind when you read about them. You may also like to talk about potential side effects with your healthcare team.
Short-term side effects from chemotherapy
You may experience some short-term side effects from your chemotherapy treatment. These may include the following:
- an achy feeling
- extreme tiredness
- sore mouth/mouth ulcers
- nausea and vomiting.
You’re unlikely to have all of these. If you have side effects, do tell your healthcare team as they may be able to help with them – there are medicines you can take to help with nausea and vomiting, for instance.
Some patients treated with ATRA or ATO will experience a condition called differentiation syndrome, also known as retinoic acid syndrome or RA syndrome. This can happen when ATRA or ATO cause the APL cells to mature into white blood cells. This is an important part of treating the disease, but when large numbers of white blood cells are present it can cause problems. It’s most likely to happen during the first three weeks of treatment of newly diagnosed or relapsed APL.
The signs and symptoms include a cough, difficulty breathing, fever, weight gain, fluid in the tissues and fluid in the membranes around the heart and lungs, which can cause a shadowing of the lungs on x-rays.
Differentiation syndrome can usually be treated with steroids. Your doctor may also recommend you stop taking ATRA/ATO for a few days.
If you have a high white blood cell count when you’re diagnosed, you may be at higher risk of differentiation syndrome. Your doctor may suggest you take steroids as a precaution to try and stop it happening.
Long-term side effects from chemotherapy
The long term effects of chemotherapy depend on which drugs you take, the intensity of your treatment and, in some cases, the total amount of the drug you take. Your specialist will discuss these potential side effects with you before you start your treatment.
Anthracyclines can cause heart damage, more often in older patients. The level of damage caused to the heart, and the likelihood of you developing this at all, will depend on the amount of anthracyclines you need to take. If you relapse and need more treatment, your healthcare team will consider what will be the most effective treatment for you, with the least possible side effects.
> For more information about side effects download or order our booklet: Chemotherapy
You may be worried about the effect of your treatment on your fertility. It’s a concern that many patients have, and one that also impacts on their partners and families too. If you’re having treatment for APL at an age when you’re thinking about having children or more children, you might want to discuss your options for protecting your fertility with your doctor.
Some chemotherapy drugs may have a temporary effect on fertility.
For men, chemotherapy drugs might affect sperm production and cause infertility. However, recent clinical studies have shown that most patients get normal sperm function back once they’ve finished chemotherapy.
For women, chemotherapy without radiotherapy is less likely to lead to infertility.
It’s very important that female patients don’t become pregnant while taking ATRA or ATO. If you’re sexually active while on treatment it’s recommended that you use at least two reliable forms of contraception.
Permanent infertility is more common in patients who’ve had a stem cell transplant after high doses of chemotherapy and/or whole body irradiation, which are less common treatment options for APL.
It’s natural to worry about the effects of treatment on any children you may have after your treatment. Lots of evidence from clinical studies has shown that a parent's cancer treatment doesn’t lead to an increased risk of cancer or other health problems in their children.