Steroids for acute lymphoblastic leukaemia

Steroids are substances that are naturally produced in the body but can be manufactured artificially as a drug. They are a very important part of treatment for acute lymphoblastic leukaemia (ALL).

Steroids can be used:

  • as part of your treatment to help get rid of leukaemia cells
  • to help reduce an allergic reaction to some chemotherapy drugs
  • in low doses to reduce nausea (feeling sick) and to improve your appetite.

Steroids can be given intravenously or as a tablet. Prednisolone and dexamethasone are the two steroids most commonly used as part of treatment for ALL.

Side effects

Mood and behaviour changes

Steroids can affect your mood. You may feel anxious or restless, or have mood swings. You may also have problems sleeping. Taking your steroids in the morning may help you sleep better. Tell your doctor or nurse if you have any of these side effects.

Tummy pain and/or indigestion

Steroids can irritate the stomach lining. Take steroid tablets with food to help protect your stomach.

Your doctor may prescribe drugs to help reduce stomach irritation. Tell your nurse or doctor if you have pain in your tummy or indigestion.

Increased appetite

Steroids can make you feel much hungrier than usual and you may gain weight. Your appetite will go back to normal when you stop taking them. If you’re worried about gaining weight, talk to your doctor or nurse.

Raised blood sugar levels

Steroids can raise your blood sugar levels. Your nurse will check your blood regularly for this. They may also test your urine for sugar. Symptoms of raised blood sugar include feeling thirsty, needing to pass urine more often and feeling tired. Tell your doctor or nurse if you have these symptoms.

If you have diabetes, your blood sugar levels may be higher than usual. Your doctor will talk to you about how to manage this. You may need to adjust your insulin or tablet dose.

Build up of fluid

You may put on weight or your ankles and legs may swell because of fluid building up. This is more common if you are taking steroids for a long time. Tell your doctor or nurse if fluid builds up. If your ankles and legs swell it can help to put your legs up on a foot stool or cushion. The swelling gets better after your treatment ends.

These side effects are temporary and will gradually disappear as the steroid dose is reduced. You should carry a card with you, or wear a Medic Alert® bracelet, stating that you are taking steroids.

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