Acute lymphoblastic leukaemia - Complications

Complications-Acute lymphoblastic leukaemia




Being immunocompromised (having a weakened immune system) is a possible complication for some people with acute leukaemia.
There are two reasons for this:
  • the lack of healthy white blood cells means your immune system is less able to fight infection
  • many of the medicines used to treat acute leukaemia can weaken the immune system
This makes you more vulnerable to developing an infection, and any infection you do have is more likely to cause serious complications.
You may be advised to take regular doses of antibiotics to prevent infections occurring. You should report any possible symptoms of an infection immediately to your GP or care team because prompt treatment may be needed to prevent serious complications.
Symptoms of infection include:
  • high temperature (fever) of 38C (101.4F) or above
  • headache 
  • aching muscles
  • diarrhoea 
  • tiredness
Avoid contact with anyone known to have an infection, even if it's a type of infection that you were previously immune to, such as chickenpox or measles. This is because your previous immunity to these conditions will probably be lower.
It's important to go outside on a regular basis, both for exercise and for your wellbeing, but you should avoid visiting crowded places and using public transport during rush hour.
Also, make sure all of your vaccinations are up-to-date. Your GP or care team will be able to advise you about this. You'll be unable to have any vaccine containing activated particles of viruses or bacteria such as the:

Bleeding

If you have acute leukaemia, you'll bleed and bruise more easily because of the low levels of platelets (clot-forming cells) in your blood.
Although major bleeding is uncommon, you need to be aware of the related symptoms that can occur in different parts of the body.
Bleeding can occur:
  • inside the skull (intracranial haemorrhage)
  • inside the lungs (pulmonary haemorrhage)
  • inside the stomach (gastrointestinal haemorrhage)
The symptoms of an intracranial haemorrhage include:
  • severe headache
  • stiff neck
  • vomiting
  • change in mental state, such as confusion
The most common symptoms of a pulmonary haemorrhage are:
  • coughing up blood from your nose and mouth
  • breathing difficulties
  • a bluish skin tone (cyanosis)
The two most common symptoms of a gastrointestinal haemorrhage are:
  • vomiting blood
  • passing stools (faeces) that are very dark or tar-like
All three types of haemorrhages should be regarded as medical emergencies. Dial 999 for an ambulance if you suspect that you or your child is experiencing a haemorrhage.

Infertility

Many of the treatments used to treat acute leukaemia can cause infertility. Infertility is often temporary, although in some cases it may be permanent.
People who are particularly at risk of becoming infertile are those who've received high doses of chemotherapyand radiotherapy in preparation for stem cell and bone marrow transplants.
It may be possible to guard against any risk of infertility before you begin your treatment. For example, men can store sperm samples. Similarly, women can have fertilised embryos stored, which can be put back into their womb following treatment.

Psychological effects of leukaemia

Being diagnosed with leukaemia can be very distressing, particularly if a cure is unlikely. At first, the news may be difficult to take in.
It can be particularly difficult if you don't currently have any leukaemia symptoms, but you know that it could present a serious problem later on. Having to wait many years to see how the leukaemia develops can be very stressful and can trigger feelings of anxiety and depression.
If you've been diagnosed with leukaemia, talking to a counsellor or psychiatrist (a doctor who specialises in treating mental health conditions) may help you combat feelings of depression and anxiety. Antidepressants or medicines that help reduce feelings of anxiety may also help you cope better.
You may find it useful to talk to other people living with leukaemia. Your GP or multidisciplinary team may be able to provide you with details of local support groups.
Macmillan Cancer Support is also an excellent resource. Its helpline number is 0808 808 00 00 and is open Monday to Friday, 9am to 8pm.  

Further information

You can read more about all aspects of living and coping with cancer at the following links:
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