Steroid treatment for chronic lymphocytic leukaemia (CLL)
Steroids commonly used to treat chronic lymphocytic leukaemia (CLL) include dexamethasone, methylprednisoline and prednisolone.
Steroids are sometimes prescribed along with chemotherapy, for example as part of the CHOP chemotherapy regimen. As well as treating the CLL, they help reduce chemotherapy-related sickness and tiredness.
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. 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 vary depending on the dose of steroids and how long you take them for.
Common side effects include:
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’re taking steroids for a long time (over months, rather than weeks) you may develop additional side effects. These may include some of the following:
swollen ankles (from fluid retention)
raised blood pressure
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 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.