Leukemias

Side Effects

Supportive care helps you improve your quality of life

Many people diagnosed with cancer are concerned about how treatment will make them feel. Though you may be anxious about possible side effects, it may help to know your multidisciplinary health care team will help you manage any that occur from the cancer or its treatments. You do not have to go through this alone.


Supportive care includes a range of services that address the physical, emotional, practical, spiritual, financial and family-related challenges of people diagnosed with cancer and their loved ones. This includes assisting your children, family members, caregivers and others close to you. Some of the resources your team may offer include pain management; counseling about nutrition, fitness, mental health or spirituality; physical therapy; occupational therapy; speech therapy; complementary medicine and others.


To most effectively manage your symptoms, your health care team will rely on you to communicate openly about how you feel.

Potentially Severe Side Effects

Though serious side effects are rare, they can occur with certain treatments. Ask your doctor whether you are at risk from the therapies in your treatment plan, how to identify the symptoms and when to seek emergency care. Report symptoms immediately so they can be treated rapidly. 

  • Infection can occur as a result of a low white blood cell count (neutropenia) or other factors. Contact your doctor immediately – do not wait until the next day – if you have any of these symptoms: oral temperature over 100.4° F, chills or sweating; body aches, chills and fatigue with or without fever; coughing, shortness of breath or painful breathing; abdominal pain; sore throat; mouth sores; painful, swollen or reddened skin; pus or drainage from an open cut or sore; pain or burning during urination; pain or sores around the anus; or vaginal discharge or itching. If you cannot reach your doctor, go to the emergency room. 
  • Immune-related adverse events (irAEs) may occur with certain immunotherapy drugs if the immune system becomes overstimulated by treatment and causes inflammation in one or more organs or systems in the body. Some irAEs can develop rapidly, becoming severe and even life-threatening without immediate medical attention. 
  • Cytokine release syndrome can occur if immune cells affected by treatment rapidly release large amounts of cytokines into the bloodstream. Symptoms may include headache, fever, nausea, rash, low blood pressure, rapid heartbeat and difficulty breathing. 
  • Infusion-related reactions most frequently occur with treatment given intravenously (IV) through a vein in your arm, usually soon after exposure to the drug. Reactions are generally mild, such as itching, rash or fever. More serious symptoms, such as shaking, chills, low blood pressure, dizziness, breathing difficulties or irregular heartbeat, can be serious or even fatal without medical intervention.
  • Tumor lysis syndrome (TLS) may occur after the treatment of a fast-growing cancer, especially certain blood cancers. Symptoms may include vomiting, diarrhea, muscle cramps or twitches, neuropathy and decreased urination. TLS can potentially cause damage to the kidneys, heart, liver or other organs. There may also be worsening of your kidney function or increases in the level of potassium in the blood.

Common Side Effects

Cancer treatment can result in different side effects. Some of the most common are shown in Table 1. Symptoms may be more intense when treatments are given in combination. Additionally, be alert for late effects. They are side effects that can occur long after treatment begins. Let your health care team know as soon as they occur. 

Side Effects Symptoms
Anemia Abnormally low red blood cell count
Bleeding problems Hemorrhaging and bruising
Bone loss Weakened bone caused by the cancer or treatment
Breathing difficulty Shortness of breath, with or without coughing
Chemo brain Brain fog, confusion and/or memory problems
Constipation Difficulty passing stools or less frequent bowel movements compared to your usual bowel habits
Diarrhea Frequent loose or watery bowel movements that are commonly an inconvenience but can become serious if left untreated
Fatigue Tiredness that is much stronger and harder to relieve than the fatigue a healthy person has
Graft-versus-Host Disease (GvHD) White blood cells from your donor (the graft) recognize healthy cells in your body (the host) as foreign and attack them
Hair loss (alopecia) Hair loss on the head, face and body
Infertility The inability to become or stay pregnant or to father a child
Lymphedema Fluid buildup from lymph node removal that causes swelling
Mouth sores Small cuts or ulcers that can affect the gums, tongue, roof of the mouth or lips
Nausea and vomiting Stomach upset that may be prevented by antiemetic (anti-nausea) medications
Neuropathy Numbness, pain, burning sensations and tingling, usually in the hands or feet at first
Neutropenia Low white blood cell count that increases the risk of infection
Pain Musculoskeletal pain and aches that occur in the muscles, bones, tendons, ligaments or nerves
Skin reactions Rash, redness and irritation or dry, flaky or peeling skin that may itch
Thrombocytopenia Low number of platelets in the blood, which can lead to bruising, bleeding, and clotting problems
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