Acute lymphoblastic leukaemia (ALL) treatment types and side effects

Different people have different responses to their treatment. Even if two people are having the same treatment, they may have a different experience. So you might not get all of these side effects – try to bear this in mind when you read about them. You may find it helpful to talk to your healthcare team about possible side effects.

We also have some important information on staying safe if you’ve got blood cancer, covering things like risk of infection and vaccinations.

Steroids can cause side effects such as:

• increased appetite
• mood changes and feeling irritable
• weight gain
• muscle weakness (especially in the legs).

Again, if you have any of these side effects it’s worth discussing this with your healthcare team, as they may be able to help.

You may experience some short-term side effects from chemotherapy treatment. They could include:

• an achy flu-like feeling
• difficulty pooing (constipation)
• frequent watery poos (diarrhoea)
• bruising and bleeding
• extreme tiredness (fatigue)
• hair loss
• infections
• rashes
• a sore mouth or mouth ulcers (mucositis)
• feeling and being sick (nausea and vomiting)
• headache (this can also happen after a lumbar puncture)
• a blood clot – this could cause leg or chest pain, redness, or swelling
• damage to the nerves (peripheral neuropathy) which causes a burning feeling or pins and needles, or a loss of feeling, often in the hands and feet
• abnormal changes in your liver − this doesn’t usually result in any symptoms, but sometimes causes the build-up of a substance called bilirubin in your body, which makes your skin look yellow (jaundice).

It’s important to remember that any side effects you get are only temporary. If you do have side effects, tell your healthcare team, as they may be able to help you manage them. For example, there are medicines you can take to help with feeling sick.

Find more information about coping with side effects.

Chemotherapy can cause a low level of white blood cells called neutrophils, which means that your body can’t fight off infections as well as it should. This is called neutropenia or being neutropenic. If you are neutropenic and get an infection, then you are at risk of a serious condition called neutropenic sepsis, which can be life-threatening.

If you think you have an infection, you should contact your healthcare team straight away. Symptoms to look out for include:

• a raised temperature (usually above 38°C)
• a temperature below 36°C
• coughing or a sore throat
• confusion or agitated behaviour, especially if this comes on suddenly (this is more common in older people)
• rapidly feeling more poorly
• fast heartbeat and breathing
• difficulty weeing (passing urine) or producing little or no urine
• pain which comes on quickly and gets worse
• shivering or shaking and feeling cold.

Find out more about managing the side effects of treatment.

With any type of chemotherapy, there’s always some risk of long-term or late side effects. These could include problems with the thyroid (a gland in your neck), heart or lungs. Some chemotherapy drugs raise the risk of developing other types of cancer later on, but this is very rare. Your ability to have a child (your fertility) may also be affected by chemotherapy.

The risk of long-term side effects will depend on how many cycles of treatment you’ve had, the intensity (strength) of the treatment and whether you’ve had a transplant or not. Every case is individual, so your healthcare team will talk to you about this in more detail.