What should I do about infections during Leukemia treatment

Managing Infections During Leukemia Treatment

Infections are a serious concern during leukemia treatment because the disease and its treatments can weaken your immune system. Let me explain what's happening and what you should do.

Why Infections Are a Risk

During leukemia treatment, your white blood cell counts often drop significantly. According to the NCCN Guidelines for Patients: Acute Myeloid Leukemia, white blood cells (WBCs or leukocytes) are the cells that fight infections. When treatment damages bone marrow—where blood cells are made—you have fewer healthy white blood cells to protect you from bacteria, viruses, and fungi.

This condition is called neutropenia (low neutrophil count). Your care team monitors your absolute neutrophil count (ANC) through regular blood tests to track your infection risk.

What You Should Do: Key Actions

1. Report Symptoms Immediately

Contact your care team right away if you experience:

• Fever (temperature of 100.4°F/38°C or higher) - this is the most important warning sign
• Chills or sweating
• Sore throat or mouth sores
• Cough or difficulty breathing
• Burning during urination
• Unusual rashes or skin changes
• Any signs of infection, even if mild

Don't wait to see if it goes away. Infections can progress quickly in people with low white blood cell counts.

2. Practice Infection Prevention

• Wash your hands frequently with soap and water, especially before eating and after using the bathroom
• Avoid crowds and people who are sick
• Stay away from people who have recently received live vaccines
• Keep your environment clean, especially bathrooms and kitchen areas
• Avoid raw or undercooked foods - eat only well-cooked foods
• Don't handle pet waste or change litter boxes
• Avoid gardening or contact with soil and plants (which can harbor fungi)

3. Maintain Regular Blood Tests

Your care team will monitor your blood counts frequently during treatment. These tests show your white blood cell levels and help determine if you need additional protective measures or treatments.

4. Take Prescribed Preventive Medications

Your doctor may prescribe:

• Antibiotics to prevent bacterial infections
• Antifungal medications to prevent fungal infections
• Antivirals to prevent certain viral infections

Take these exactly as prescribed, even if you feel well.

5. Communicate with Your Care Team

According to the NCCN Guidelines, it's important to have regular conversations with your care team about:

• Your infection risk level based on your current blood counts
• What symptoms require immediate attention
• How to reach your care team in emergencies
• Whether you need to avoid certain activities

Questions to Ask Your Care Team

• What is my current white blood cell count and what does it mean for my infection risk?
• What symptoms should I report immediately?
• Should I take preventive antibiotics or antifungal medications?
• Are there activities I should avoid during treatment?
• How often will my blood counts be checked?
• What should I do if I develop a fever when it's after hours or on a weekend?
• Do I need to avoid certain foods or environments?

Important Reminders

Infections during leukemia treatment are common but manageable when you stay alert and communicate with your care team. The key is catching any signs early and getting prompt treatment.

Your care team includes specialists trained in managing these complications. Don't hesitate to call with concerns—it's always better to check something out than to wait and risk a serious infection.

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This information is for educational purposes only. Always consult your healthcare team for personalized medical advice and decisions.

Sources: NCCN Guidelines for Patients: Acute Myeloid Leukemia, 2025; NCCN Guidelines for Patients: Chronic Myeloid Leukemia, 2025