Managing Side Effects of Acute Lymphoblastic Leukemia Induction Chemotherapy

Most adverse effects are treatable

• Chemotherapy can put ALL patients into remission, but they cause side effects
• Nausea, vomiting, liver toxicity, and tumor lysis syndrome are all possible
• Some patients will require an extended hospital stay to manage side effects

With induction chemotherapy, the aim is to put acute lymphoblastic leukemia (ALL) patients into complete remission. However, as these strong drugs kill cancer cells, they produce a number of side effects, some of which can be significant.

“Once the induction therapy is completed, and hopefully it works and patients are in remission, they’re not out of the woods,” Dr. Olalekan Oluwole, assistant professor of medicine in Hematology/Oncology at Vanderbilt University Medical Center, tells SurvivorNet Connect.

Potential complications include nausea and vomiting, low blood cell counts, tumor lysis syndrome, and organ toxicity – particularly to the liver, which has to process these drugs. Fortunately, many of these adverse effects are manageable. Nausea and vomiting can be prevented with antiemetics. Byproducts of tumor lysis syndrome are removed from the blood with a method similar to dialysis. Infections require antibiotics. Sometimes side effects will necessitate an extended hospital stay.

Dr. Oluwole says patients should eventually be able to complete their treatments in the outpatient setting. “They only need to be admitted to the hospital if that were to be necessary,” he adds.