Steroid treatment for chronic lymphocytic leukaemia

Steroids commonly used in CLL treatment include dexamethasone, methylprednisolone and prednisolone. These steroids are prescribed by doctors to help patients, and have nothing to do with the kind of steroids used by some bodybuilders.

Sometimes high-dose steroid treatment, called high-dose methylprednisolone (HDMP), is used to treat CLL. The steroids can be given as tablets or into a vein as a drip. Usually, the treatment is given for five days every four weeks. You may be prescribed antibiotics or antiviral drugs to help prevent infection| during your treatment.

You may also be given treatment with steroids if your red blood cell count falls very quickly because of a condition called autoimmune haemolytic anaemia|.

Side effects

Side effects vary depending on the dose of steroids and how long you are taking them for.

Common side effects include:

• indigestion
• increased appetite
• feeling more energetic
• difficulty sleeping.

Taking steroids with food can help to reduce indigestion. Your doctor may also prescribe medication to prevent it. You should always tell your doctor if you have stomach pains when you’re taking steroids. If you have difficulty sleeping, taking steroids earlier in the day (before 6pm) may help.

If you are taking steroids for a long time (over months, rather than weeks) you may develop additional side effects. These may include some of the following:

• frequent infections
• weight gain
• swollen ankles (from fluid retention)
• raised blood pressure
• muscle weakness
• a higher level of sugar in your blood
• sugar in your urine.

These side effects are temporary and will gradually disappear when you stop taking steroids.

People who need to take steroids continually for a long time are also at increased risk of bone thinning (osteoporosis), and may be prescribed calcium and vitamin D supplements to help protect their bones. Some people may also be prescribed drugs called bisphosphonates| to strengthen their bones.

It’s unusual for people with CLL to take steroids for so long that all these side effects occur. You shouldn’t suddenly stop taking steroids without your doctor’s advice as this can be very dangerous. If you need to stop treatment, your doctor will tell you how to manage this and will gradually reduce your dose of steroids over a period of time.