Blood cancer and the treatment of blood cancer can cause mild to serious health complications and side effects. Some of these symptoms can be handled with ongoing supportive care and medicines. Others may be medical emergencies, and it may require immediate attention. In this article, we will discuss complications caused by treatment and how to manage it. Always consult with your doctor if you experience new or worsening symptoms. 

Kidney Impairment 

Blood cancer patients may have severe problems with kidney function for two principal reasons. One is the excretion of large amounts of monoclonal proteins in the urine. This excess protein can harm the kidney filtration apparatus and the channels or tubules important in urine formation. Another reason is that patients with blood cancer often have high levels of calcium (hypercalcemia) or uric acid (hyperuricemia) in the blood. When bones are damaged, calcium is released into the blood. High calcium levels in the blood may cause dehydration that can damage the kidneys. Patients may need dialysis if kidney function does not improve with myeloma treatment.

In rare cases, when patients have very recent or acute kidney failure due to high levels of antibody proteins in the blood, a procedure known as plasmapheresis and exchange may help limit kidney damage, though this controversial approach. It temporarily removes proteins from the blood, which will accumulate again if the source of the problem (the myeloma) is not eliminated. The most critical and successful treatment for kidney failure is treating blood cancer.

Acute Myeloid Leukemia

Blood cancer patients are more prone to developing acute myeloid leukemia (AML), especially after being treated with cytotoxic anticancer drugs. AML development, however, is a rare occurrence.

Infertility due to blood cancer treatment 

Many blood cancer treatments cause infertility. This is often temporary but, in some cases, it can be permanent. People at risk of permanent infertility have received high doses of chemotherapy and radiotherapy in preparation for bone marrow or stem cell transplants.

Your doctor can discuss the risk of infertility in certain circumstances. Doing certain things to help keep your fertility before you start your treatment may be possible. For example, men can have their sperm samples stored, and women can have eggs or fertilized embryos stored, which can then be placed back into their wombs after the treatment.

But as AML is an aggressive condition that develops rapidly, there may not always be time to do this before treatment needs to start.

Early menopause

Some blood cancer treatments may affect the normal functioning of the ovaries. This can sometimes cause infertility and an earlier than expected onset of menopause, even at a young age. The beginning of menopause in these circumstances can be sudden and, understandably, very stressful. Hormone changes can lead to many of the classic symptoms of menopause, including menstrual changes, hot flushes, sweating, dry skin, vaginal dryness and vaginal itchiness, headache and pains. Some women experience decreased sexual drive, anxiety and even depressive symptoms. Women should consult a gynecologist, who will advise them on the appropriate steps to help reduce their symptoms.

Menopausal symptoms can be particularly troubling for some women. In these women, hormone replacement therapy (HRT) can be helpful. The aim of HRT is to restore estrogen levels to near normal, minimizing symptoms.

Bleeding and Bruising (Thrombocytopenia) and blood cancer treatment

Some blood cancer treatments, such as chemotherapy and targeted therapy, can maximize your risk of bleeding and bruising. These treatments may lower the number of platelets in the blood. Platelets are the cells that help your blood to clot and stop bleeding. When your platelet count is low, you may bruise or bleed frequently. It can also cause tiny purple or red spots on your skin. This condition is called thrombocytopenia. You must inform your doctor if you notice any of these changes.

Ways to manage bleeding and bruising

If you are at increased risk of bleeding and bruising, follow the following steps:

Avoid certain medicines

Avoid certain medicines. Many over-the-counter medications contain aspirin or ibuprofen, which may increase your risk of bleeding. If you have any doubt, you can check the label of the medicines. Ask your doctor to list the medications and products you should avoid taking. You may also be advised to control or prevent alcohol if your platelet count is low.

Take extra care to prevent bleeding

Take every care to prevent bleeding. Brush your teeth gently with a very soft toothbrush. Wear shoes inside the house also. Be extra careful while using sharp objects. Use an electric shaver, not a razor, to avoid bleeding. Use lotion and a lip balm to prevent dry, chapped skin and lips. Tell your oncologist if you are constipated or notice bleeding from your rectum.

Care for bleeding or bruising

Care for bleeding or bruising. If you start to bleed, press down firmly on the area with a clean cloth. Keep pressing until the bleeding stops, if you get injured, put ice on the area.

Side effects of treatment 

The treatments used for managing blood cancer can have side effects, and you could experience the side effects of treatment and some results of your cancer throughout your treatment. 

• Leukopenia (low WBCs)
• Neutropenia (low neutrophils, a type of WBC)
• Lymphedema (swelling of lymph nodes)
• Blood clots

Chimeric antigen receptor T-cell (CAR-T) therapy, a type of immunotherapy used to treat cancer, can cause fevers, hypotension (low blood pressure), bleeding and blood clotting problems, cognitive (thinking) impairment, and more.2    

A bone marrow transplant may result in graft vs host disease or graft rejection, which can cause symptoms of nausea, vomiting, fevers, diarrhea, and abdominal pain. 

Call your oncologist if you have more severe problems, including:

• Bleeding doesnt stop after a few minutes.
• Bleeding from your mouth, nose, or when you vomit.
• There is bleeding from your vagina when you are not having your menstruation.
• Urine is red or pink.
• Stools are black or bloody.
• Bleeding during your period is heavier or lasts longer than usual.