Possible side effects of chemotherapy
Chemo drugs attack cells that are dividing quickly, which is why they work against
cancer cells. But other cells in the body, such as those in the bone marrow (where new
blood cells are made), the lining of the mouth and intestines, and the hair follicles, also
divide quickly. These cells can also be affected by chemotherapy, which can lead to side
effects.
The side effects of chemo depend on the type and dose of drugs given and the length of
treatment. These side effects can include:
· Hair loss
· Mouth sores
· Loss of appetite
· Diarrhea
· Nausea and vomiting
· Increased risk of infections (because of low white blood cell counts)
· Bruising and bleeding easily (from low platelet counts)
· Fatigue (caused by low red blood cell counts)
The problems with blood cell counts are often caused by the leukemia itself at first. They
might get worse during the first part of treatment because of the chemotherapy, but they
will probably improve as the leukemia cells are killed off and the normal cells in the bone
marrow recover.
The side effects above usually go away when treatment is finished. There are often ways
to reduce these side effects. For instance, drugs can be given to help prevent or reduce
nausea and vomiting. Other drugs known as growth factors can be given to help keep the
blood cell counts higher.
Tumor lysis syndrome is another possible side effect of chemotherapy. It can happen in
patients who had large numbers of leukemia cells in the body before treatment. When
chemo kills these cells, they break open and release their contents into the bloodstream.
This can overwhelm the kidneys, which aren’t able to get rid of all of these substances at
once. Too much of certain minerals can also affect the heart and nervous system. This
problem can be prevented by making sure the child gets lots of fluids during treatment
and by giving certain drugs, such as bicarbonate, allopurinol, and rasburicase, which help
the body get rid of these substances.
Some chemo drugs can also have specific side effects that are not listed above. Be sure to
ask your child’s doctor or nurse about any specific side effects you should watch for and
about what you can do to help reduce these side effects.
Chemotherapy given directly into the cerebrospinal fluid (CSF) around the brain and
spinal cord (known as intrathecal chemotherapy) can have its own side effects, although
these are not common. Intrathecal chemo may cause trouble thinking or even seizures in
some children.
Chemo can also cause some long-term side effects. These are discussed in the section
“What happens after treatment for childhood leukemia?”
For more information on chemotherapy, see the Chemotherapy section of our website, or
our document A Guide to Chemotherapy.