What to expect from chemotherapy for acute lymphoblastic leukaemia

Treatment is designed to clear leukaemia cells from the blood and bone marrow. It may begin with an intensive phase, followed by further treatment to reduce the chance of remaining cells growing again. Medicines may be given through a vein, by mouth, or into the fluid around the brain and spinal cord. The exact combination depends on age, overall health, laboratory findings and how the leukaemia responds.

You may spend time in hospital during intensive treatment, particularly when blood counts are low. Doctors monitor blood cells, electrolytes, liver function and signs of infection. Transfusions, fluids, anti-sickness medicines and medicines to prevent or treat infection can be part of the plan. Hair loss, tiredness, nausea, mouth soreness and reduced appetite can occur, but effects vary between people.

Keep a written list of medicines, allergies and symptoms. Ask which medicines should be paused, how to protect your mouth, and what food and activity advice applies while your immune system is weakened. Plan help with transport, meals and daily tasks. Tell the team before treatment if you have fever, a new infection, dental problems, or difficulty eating and drinking.

Contact your oncology team promptly for a fever or chills, a new cough, shortness of breath, unusual bleeding, severe diarrhoea, repeated vomiting, confusion, or inability to drink. Seek urgent help for heavy bleeding, severe breathing difficulty, a seizure, or sudden weakness. Follow the temperature and emergency instructions supplied by your hospital, since low white-cell counts can make infection serious.

Ask which phase starts first, how treatment response will be checked, whether a central line is needed, which side effects need a same-day call, and how fertility, school, work or childcare may be affected.