Late effects of acute lymphoblastic leukaemia treatment
Sometimes side effects from acute lymphoblastic leukaemia (ALL) treatment may continue or develop months or years after treatment. These are called late effects.
Unfortunately, treatment for acute lymphoblastic leukaemia (ALL) can sometimes cause side effects that are permanent or happen months or years later.
These will not happen to everyone. Your doctor or specialist nurse can explain how likely they are to affect you. They may give you advice about ways to prevent or manage long-term effects. This may include:
- telling them about certain symptoms
- having regular tests or check-ups with your GP or at a hospital clinic
- having treatments or medicines
- making lifestyle changes.
Some leukaemia treatments can increase your risk of heart problems later in life. After these treatments, your doctor may arrange tests to check your heart every few years. They may also advise you to have regular blood pressure checks and blood tests to check your cholesterol levels. Your GP can arrange this for you.
We have more information about cancer treatment and your heart.
People who have had intensive chemotherapy or a stem cell transplant have a slightly higher risk of developing a different cancer years later. It is important to go for any cancer screening tests when you are invited. Screening tests:
- look for early changes that can be treated to prevent cancer
- find cancer at an early stage when it is easier to treat.
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Ask your doctor or specialist nurse what screening you should have and when you should have this.
If you are thinking about trying to get pregnant, talk to your doctor. They can give you advice based on the leukaemia treatment you had and your age. They can help you arrange tests to check if your fertility has been affected by treatment. They can arrange for you to see a fertility specialist for more advice if needed.
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Treatment for leukaemia can cause some women to have an earlier menopause. Your doctor can tell you if this is likely.
You may have blood tests to check for signs of the menopause. Some women have hormonal replacement therapy (HRT) to reduce menopausal symptoms. Your doctor will explain any possible benefits and risks of HRT.
We have more information about menopause after cancer treatment.
Treatment for ALL usually involves taking steroids. Having high-dose steroid treatment, or taking steroids for 3 months or more, may affect your bone health later in life. You may develop bone thinning (osteoporosis) and have a higher risk of bone fractures.
If you had treatment for ALL as a teenager or young adult, you also have a risk of developing a condition called avascular necrosis. This affects the blood supply in the bones. Symptoms include painful joints or problems moving joints. If you have these symptoms at any time after your treatment, tell your GP, doctor or specialist nurse so they can help.
Changes to your bone health do not always cause symptoms. Your doctor may arrange a scan every few years so any changes can be found and treated early.
We have more information about bone health after cancer treatments.
Below is a sample of the sources used in our acute lymphoblastic leukaemia (ALL) information. If you would like more information about the sources we use, please contact us at firstname.lastname@example.org
Hoelzer D, et al. Acute lymphoblastic leukaemia: ESMO clinical practice guidelines. Annals of Oncology. 2016. 27 (Supplement 5): v69-v82.
National Institute for Health and Care Excellence. Blood and bone marrow cancer. www.nice.org.uk/guidance/topic/conditions-and-diseases/blood-and-immune-system-conditions/blood-and-bone-marrow-cancers (accessed July 2018).
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Anne Parker, Consultant Haematologist.
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