Serious Side Effects. Serious chemotherapy side effects can also occur and may vary depending on the specific drugs used. They include:

• Neutropenia is a severe drop in white blood cells. Neutropenia increases the chance for infection and is a potentially life-threatening condition. Drugs called granulocyte colony stimulating factor (G-CSF) are used to help boost white blood cell count. These drugs, which include filgrastim (Neupogen) and pegfilgrastim (Neulasta), can help lessen the risk for neutropenia occurrence and, if neutropenia does occur, to reduce its length and severity. Patients should also use lifestyle precautions to prevent infection. (See Transplantation section of this report.)
• Anemia is a lack of red blood cells. Erythropoietin stimulates red blood cell (hemoglobin) production and can help reduce or prevent this side effect. It is available as epoetin alfa (Epogen, Procrit) and darbepoetin alfa (Aranesp). In patients with cancer, these drugs should be used to treat only anemia associated with chemotherapy and to increase hemoglobin levels to no more than 12 g/dL. Treatment should stop as soon as chemotherapy is complete. These drugs may not be safe or appropriate for all patients.
• Liver and kidney damage
• Abnormal blood clotting (thrombocytopenia)
• Allergic reaction

Long-Term Complications.

• Fatigue and Somatic Symptoms. Chemotherapy has been associated with long-term somatic symptoms, which are general conditions, such as fatigue and aches and pains that have no apparent physical basis. Fatigue is especially common after chemotherapy and may last for several years.
• The most serious long-term complications from chemotherapy are secondary cancers, particularly in people over age 40.
• Infertility is a risk, particularly with the use of cyclophosphamide.
• Some patients develop osteoporosis (bone thinning) and damage in bone cells.
• Regimens containing certain drugs, particularly doxorubicin or mitoxantrone, increase the risk for future heart failure.

In general, these serious late side effects are dependent on the cumulative drug dose and rate of administration.

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Non Biologic Therapy (Immunotherapy)

Review Date: 01/27/2011
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)