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.

About 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.

Changes to heart health

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.

Second cancers

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.

We have more information about:

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.

We have more information about:

Early menopause

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.

Changes to bone health

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.

About our information

  • Reviewers

    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.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.