Being immunocompromised (having a weakened immune system) is a possible complication for some patients with acute leukaemia.

There are two reasons for this:

• the lack of healthy white blood cells means that your immune system is less able to fight infection
• many of the medicines used to treat acute leukaemia can weaken the immune system

This means that you are more vulnerable to developing an infection, and that any infection you have has an increased potential to cause serious complications.

You may be advised to take regular doses of antibiotics to prevent infections occurring. You should immediately report any possible symptoms of an infection to your GP or care team because prompt treatment may be required to prevent serious complications.

Symptoms of infection include:

• high temperature (fever) of 38C (101.4F) or above
• headache
• aching muscles
• diarrhoea
• tiredness

Avoid contact with anyone who is known to have an infection, even if it is a type of infection that you were previously immune to, such as chickenpox or measles. This is because your previous immunity to these conditions will probably be lower.

While it is important to go outside on a regular basis, both for exercise and for your psychological wellbeing, avoid visiting crowded places and using public transport during rush hour.

Also ensure that all of your vaccinations are up-to-date. Your GP or care team will be able to advise you about this. You will be unable to have any vaccine containing activated particles of viruses of bacteria such as:

• the mumps, measles and rubella (MMR) vaccine
• the polio vaccine
• the oral typhoid vaccine
• the BCG vaccine (used to vaccinate against tuberculosis)
• the yellow fever vaccine

Bleeding

If you have acute leukaemia, you will bleed and bruise more easily due to the low levels of platelets (clot-forming cells) in your blood. Bleeding may also be excessive when it does occur.

Bleeding can occur:

• inside the skull (intracranial haemorrhage)
• inside the lungs (pulmonary haemorrhage)
• inside the stomach (gastrointestinal haemorrhage)

The symptoms of an intracranial haemorrhage include:

• severe headache
• stiff neck
• vomiting
• change in mental state, such as confusion

The most common symptoms of a pulmonary haemorrhage are:

• coughing up blood from your nose and mouth
• breathing difficulties
• a bluish skin tone (cyanosis)

The two most common symptoms of a gastrointestinal haemorrhage are:

• vomiting blood
• passing stools (faeces) that are very dark or tar-like

All three types of haemorrhages should be regarded as medical emergencies. Dial 999 to request an ambulance if you suspect that you or your child is experiencing a haemorrhage.

Infertility

Many of the treatments that are used to treat acute leukaemia can cause infertility. Infertility is often temporary, although in some cases it may be permanent.

People who are particularly at risk of becoming infertile are those who have received high doses of chemotherapy and radiotherapy in preparation for bone marrow or stem cell transplantation.

It may be possible to guard against any risk of infertility before you begin your treatment. For example, men can have samples of their sperm stored. Similarly, women can have fertilised embryos stored, which can then be placed back into their womb following treatment.

Read more about infertility.  

Psychological effects of leukaemia

Receiving a diagnosis of leukaemia can be very distressing, particularly if it is unlikely that your condition can be cured. At first, the news may be difficult to take in.

The situation can be made worse if you are confronted with the knowledge that even though your leukaemia may not currently be causing any symptoms, it could be a serious problem in later life. Having to wait many years to see how the leukaemia develops can be immensely stressful and can trigger feelings of stress, anxiety and depression.

If you have been diagnosed with leukaemia, talking to a counsellor or psychiatrist (a doctor who specialises in treating mental health conditions) may help you to combat feelings of depression and anxiety. Antidepressants or medicines that help to reduce feelings of anxiety may also help you cope better with the condition.

You may find it useful to talk to other people who are living with leukaemia. Your GP or multidisciplinary team may be able to provide you with details of local support groups.

Another excellent resource is Macmillan Cancer Support. Their helpline number is 0808 808 00 00 and is open Monday to Friday, 9am–8pm.  

Further information

You can read more information on all aspects of living and coping with cancer at the following links:

• living with cancer – including information on treatment, support and personal experiences of cancer
• living with acute lymphoblastic leukaemia – Cancer Research UK