Treatment Side Effects - Infections

The risk of infections is a potential side effect with blood cancer treatment. Frequent infections are also common as a symptom of blood cancer. Infections occur when the immune system is unable to quickly destroy harmful invaders, like viruses, bacteria, and fungi. During an infection, these germs multiply in a person's body. Infections can start anywhere on the body, including the skin, the mouth, the lungs, the urinary tract, or the genitals.

Common signs of infection include:

• A fever of 100.5º F or higher
• Sweating or chills
• Sore throat
• Coughing
• Abdominal pain
• Diarrhea
• Frequent urination or pain while urinating
• Redness, swelling, or pain around a wound
• Unusual vaginal discharge or odor¹

Infections can range in severity from mild to very serious, and infections are one of the most common complications from cancer treatment. If the infection becomes overwhelming to the body, it may cause a harmful response called sepsis. Sepsis can be life-threatening and can result in organ failure, tissue damage, and possibly death.^2,3

Why does blood cancer treatment increase the risk of infections?

• Chemotherapy targets rapidly dividing cells, which includes blood cancer cells but can also affect healthy blood cells in the bone marrow. Chemotherapy can cause decreased white blood cells (WBCs), which increases the risk of infection as WBCs are the body's first line of defense against foreign invaders.⁴
• Stem cell transplants can increase a person's risk of infection as they use high doses of chemotherapy to kill cancer cells and causes a severe weakening of the immune system until the replaced stem cells take effect.⁴
• Targeted therapy focuses on key features present in cancer cells, which hopefully provides treatment with less effect on normal cells. However, targeted therapies still can cause side effects, and a common side effect of certain targeted therapies is an increased risk of infection.⁵
• Immunotherapy is a type of treatment that aims to increase the immune system's ability to fight the cancer, but in doing this, sometimes the immunotherapy changes the way the immune system responds to foreign invaders.⁴
• Surgery for blood cancer (like a splenectomy) involves cutting into the body, and any opening into the body has the potential to introduce germs, which can grow and become an infection.⁴
• Radiation therapy can lower white blood cell counts, increasing the risk of infection.⁴

Reducing the risk of infections

There are several steps that can be taken to help reduce the risk of infection, including:

• Washing hands often and thoroughly
• Avoiding contact with people who are ill
• Avoiding crowds
• Keeping cuts or wounds clean, and using antiseptic and bandages
• Bathing or showering every day to remove germs from the skin
• Eating food that has been properly cooked
• Washing fruit and vegetables before eating
• Protecting hands with gloves during gardening, cleaning up animal waste, or cleaning up after small children^3,6

Treating infections

The treatment for infections is based on the type of germ that is causing the infection, as well as the severity of the infection. For bacterial infections, antibiotics are typically used. Sometimes, a combination of antibiotics is used to get a bacterial infection under control. For fungal infections, antifungal medications may be used, and for infections caused by a virus, an antiviral medication may be used.²