Having a weakened immune system (being immunocompromised) is a possible complication for some people with acute lymphoblastic leukaemia.

A weakened immune system may be caused by a lack of healthy white blood cells, which means your immune system is less able to fight infection.

It can also be caused by many of the medicines used to treat acute lymphoblastic leukaemia.

Having a weakened immune system makes you more vulnerable to infections. It also means that any infection you have is more likely to cause serious complications.

You may be advised to take regular doses of antibiotics to prevent infections.

Tell your care team or GP immediately if you have any symptoms of an infection because prompt treatment may be needed to prevent serious complications.

Symptoms of infection may include:

  • high temperature
  • headache
  • aching muscles
  • diarrhoea 
  • tiredness

Avoid contact with anyone who has an infection, even if it's a condition you were immune to in the past, such as chickenpox or measles. This is because your previous immunity to these conditions will probably be lower.

It's important to go outside regularly for exercise and for your wellbeing, but you should avoid crowded places and using public transport during rush hour.

Also, make sure all your vaccinations are up to date. Your GP or care team will be able to advise you about this.

You will not be able to have any vaccine containing "live" viruses or bacteria such as the:


If you have acute leukaemia, you'll bleed and bruise more easily because of the low levels of platelets (clot-forming cells) in your blood.

Although heavy bleeding is uncommon, you need to be aware of the symptoms that can happen in different parts of the body.

Bleeding can happen:

  • inside the skull (intracranial haemorrhage)
  • inside the lungs (pulmonary haemorrhage)
  • inside the stomach (gastrointestinal haemorrhage)

All 3 types of heavy bleed (haemorrhage) are medical emergencies.

Call 999 for an ambulance if you think you or your child is having a heavy bleed.

Symptoms of an intracranial haemorrhage are:

  • severe headache
  • stiff neck
  • being sick
  • change in mental state, such as confusion

Common symptoms of a pulmonary haemorrhage are:

  • coughing up blood from your nose and mouth
  • breathing difficulties
  • a bluish skin tone (cyanosis)

Common symptoms of a gastrointestinal haemorrhage are:

  • vomiting blood
  • poo that is very dark or tar-like


Many of the medicines used to treat acute lymphoblastic leukaemia can cause infertility.

People who are particularly at risk of becoming permanently infertile are those who've received high doses of chemotherapy and radiotherapy in preparation for a stem cell and bone marrow transplant.

It may be possible to guard against any risk of infertility before you begin your treatment. For example, men can store sperm samples. Similarly, women can have fertilised embryos stored, which can be put into their womb following treatment.

Psychological effects of leukaemia

Being diagnosed with leukaemia can be very distressing, particularly if a cure is unlikely. At first, the news may be difficult to take in.

It can be particularly difficult if you do not currently have any leukaemia symptoms, but you know that it could cause a serious problem later on. Having to wait many years to see how the leukaemia develops can be very stressful and can trigger feelings of anxiety and depression.

If you've been diagnosed with leukaemia, talking to a counsellor or a doctor who specialises in treating mental health conditions (psychiatrist) may help you combat feelings of depression and anxiety. Antidepressants or medicines that help reduce feelings of anxiety may also help you cope better.

You may find it useful to talk to other people living with leukaemia. Your GP or multidisciplinary team may be able to provide you with details of local support groups.

You can also contact Macmillan Cancer Support. Its helpline is 0808 808 00 00 (7 days a week, 8am to 8pm).

Further information

Find out more about living and coping with cancer: