Diffuse large B-cell lymphoma (DLBCL) treatment and 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.

Treatment can cause some side effects, but everyone is different and you’re unlikely to have all of the potential side effects.

Let your healthcare team know about any side effects you have, because often they will be able to help you manage them – for example, by prescribing you anti-sickness drugs (anti-emetics).

• feeling achy
• hair loss (alopecia)
• frequent watery poos (diarrhoea)
• difficulty pooing (constipation)
• extreme tiredness (fatigue)
• infections
• loss of appetite
• bruising
• risk of bleeding
• being short of breath
• mouth sores
• feeling and being sick (nausea and vomiting)

Having chemotherapy can also slightly increase your risk of getting a new, second cancer. Your healthcare team will be able to discuss this with you.

• tingling or numbness in your fingers or toes, which might make it hard to do things like doing up buttons – you’ll be assessed for this before each chemotherapy session and if it’s severe you might take a lower dose of vincristine or stop taking it entirely
• constipation – your healthcare team might give you some medicine (a laxative) to help with this

• mood changes such as being abnormally or excessively active (hyperactivity), feeling emotional, elated, low or lacking energy
• increase in appetite
• inability to sleep (insomnia) − check with your healthcare team whether you can try taking your tablets in the morning rather than the evening
• changes in blood sugar, causing you to wee more often, have an unexplained thirst or feel dizzy and light-headed − if this happens, contact your healthcare team

We have more information about coping with changes to your body or appearance.

While you’re having treatment, you have more chance of developing an infection, and a minor infection could become more serious.

Symptoms of infection include:

• a raised temperature (usually above 38°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

Symptoms of infection can be less obvious because of your NHL, or if you are taking paracetamol-based medicines. If you’re in any doubt you should contact your healthcare team straight away.

For advice about ways to lower your risk of developing infections, download our fact sheet Understanding infection.

You might need supportive care alongside your other treatment. Supportive care involves dealing with complications of your illness or your treatment. This could include:

• stopping you feeling sick
• avoiding or treating constipation
• preventing gout, which causes painful swelling in the feet
• mouth care
• blood transfusions
• pain management
• diet planning