Chemotherapy drugs are toxic by nature, so can have side effects which are very difficult for children to tolerate and can be very dangerous.
It is not only the leukaemia cells of the bone marrow that are destroyed, but the normal bone marrow cells too and the cells in the body that divide rapidly such as hair cells and cells lining the gut.
Clockwise from top left
Mucositis - can be extremely painful and remember can occur on all mucous membranes throughout the body including those internally. This can make eating/ feeding extremely painful and often leads to children requiring NG feeding or even TPN. (image by Blunderbuss, used under Creative Commons License)
Nausea/vomiting - a common side-effect of chemotherapurtic agents. Children will receive anti-emetics alongside their therapy. This may contribute to the poor oral intake seen with mucositis.
Abscess (and other Neutropenic sepsis) - In consequence of the body’s normal immune fighting blood cells being wiped out by the chemotherapy as well as the cancerous cells children are often neutropenic for long periods of time. This means even simple viral infections can be potentially fatal. High vigilance is required when treating neutropenic children and any temperature over 38.5 necessitates children having blood (usually from in dwelling central access) throat and urine cultures performed and commencing IV antibiotics pending results of these blood cultures.
Bruising/bleeding - Just as white blood cells of the bone marrow are destroyed with chemotherapy, so are the platelets needed for normal blood clotting. Platelet counts can become so low that children require platelet transfusions. (Image by Labiv from Wikipedia. Used under Creative Commons 3.0)
