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NCCN Guidelines for Patients



Acute Lymphoblastic Leukemia, Version 1.2017


Cancer treatments

Supportive care

Side effects of radiation therapy

Side effects of radiation therapy depend on the dose

and the area of your body being treated. Most of

the side effects go away soon after treatment ends.

Some of the most common side effects of radiation

therapy include:



Skin changes



Hair loss






Upset stomach




Supportive care

Supportive care is treatment given to relieve the

health problems caused by cancer and side effects

of cancer treatment. Managing symptoms and side

effects with supportive care is important for your

quality of life and treatment outcome. Supportive

care options for common health problems that affect

patients with ALL are described next.

Nausea and vomiting

Many chemotherapy drugs can cause nausea and

vomiting. Medicine can be given to lessen or prevent

this side effect. Drugs that prevent nausea and

vomiting are called antiemetics. Antiemetics should

be given before starting chemotherapy treatment.


NCCN Guidelines for Patients


: Nausea and


. These guidelines are available for free at .

Low blood cell counts

ALL and its treatment can cause low blood cell

counts. Very low blood cell counts can cause a

number of health problems. But, there are many

ways to manage this side effect.

A low number of red blood cells can cause fatigue

and shortness of breath. If your red blood cell count

is low, you may be given a transfusion of red blood

cells. A low number of platelets can cause you to

bleed or bruise easily. A transfusion of platelets may

be given if your platelet count is very low.

Having a low number of white blood cells is also very

common during treatment for ALL. Transfusions are

not used to treat low white blood cell counts. Instead,

you may be given a type of drug called a growth


Growth factors help the bone marrow to make new

healthy white blood cells. This helps to increase the

white blood cell count quickly. Growth factors are

recommended during parts of ALL treatment that

lower (suppress) the bone marrow’s ability to make

new blood cells.

Infection risks

ALL and its treatment can cause very low white blood

cell counts. White blood cells are part of the immune

system and help fight off infection and disease.

Having a very low white blood cell count puts you at

risk for infections.

Medicines may be given to prevent or treat

infections. Antibiotics can prevent or treat infections

caused by bacteria. An antifungal is medicine for

infection caused by fungus. An antiviral is medicine

for infection caused by a virus. Your doctor may also

suggest that you get vaccines for pneumonia and the