Other considerations during therapy for leukemia

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Learn how to safeguard children with leukemia against infection and other precautions they should be taking during treatment.

Key points

  • It is important for children with leukemia to avoid infections as they have a suppressed immune system while on treatment and are more prone to infection.
  • Children who are being treated for leukemia should avoid herbal medicines as they can interact with chemotherapy drugs and cause serious side effects.
  • Teachers in hospital can work with children with leukemia.
  • Children with leukemia must take precautions against sun exposure and bug bites.

Children receiving treatment for leukemia will have a suppressed immune system. As such, they will have to take precautions in avoiding infections and certain immunizations. It is also important for children with leukemia to avoid herbal medicines and take all of their prescribed medicines properly.


To prevent developing some diseases caused by bacteria or viruses, healthy children receive immunizations at various ages.

During leukemia treatment, your child's immune system is suppressed. They are more prone to catching infections caused by bacteria, viruses, and fungi than healthy children.

Vaccines are classified as either live or inactive. In live vaccines a very small amount of the actual live virus or bacteria is injected. Children on chemotherapy should not receive any live vaccines. In contrast, an inactivated vaccine is a dead virus or bacteria.

Since your child will have a suppressed immune system while on treatment, it may be better to avoid all vaccinations until the end of therapy. However, your child should receive the annual flu vaccine injection.

Family members and anyone else in the household should also make sure all their vaccinations are up-to-date. Flu vaccines for all family members and caregivers are encouraged.

Speak to your doctor if you have any questions about other vaccinations.

Infection control at home

Your child should avoid contact with people who may be sick and have symptoms of infection. However, it is very important to treat your child as you normally would and not isolate them from the outside world. While it may be best to avoid crowded places during the flu season, it is important to try and maintain a typical routine for your child and family. For example, children can go to the mall and attend birthday parties and other social functions. You do not need to sterilize your home environment. Following routine hygiene procedures such as hand-washing is the best way to minimize any risk of infection.


Tell your doctor immediately if your child is exposed to the varicella virus (chickenpox), especially if your child has no history of chickenpox infection or did not receive the chickenpox vaccine prior to his leukemia diagnosis. Chickenpox exposure is defined as face-to-face contact for a minimum of one hour with a person who has the chickenpox or develops the chickenpox in the following days. Promptly notify the treatment team so they can give your child a chickenpox antibody.

In the case of exposure to chickenpox, a chicken pox antibody may be given by a needle in the leg muscle. It is effective if given within 96 hours of exposure to a person with chickenpox. The chickenpox antibody may prevent your child from developing the chickenpox or decrease the severity of the chickenpox infection.


It is safe to have pets in the house, but make sure your pet's immunizations are up to date and they receive their regular check-ups. It is safe to keep dog and cat litter in the house, but make sure you change it when necessary.

Herbal and natural products and vitamins

Herbal remedies are often perceived as safer than conventional medicines because they are
"natural. " However, "natural " does not mean "benign" or "completely safe." Like conventional prescription and over-the-counter drugs, herbal remedies contain pharmacologically active ingredients – in some cases, powerful ones. Like conventional medicines, herbal remedies can have side effects of their own and can interact with other drugs.

Because trials of herbal remedies have rarely been carried out, particularly in children, the necessary information on most products to know how frequently they cause side effects or adversely affect other actions of other drugs is unknown. Speak to your doctor about any questions or concerns you may have about herbal medicines.

It is best that your child not take any herbal medicine or dietary supplements during treatment, including vitamins, unless your child's doctor has specifically recommended them. This is because they might interact with the chemotherapy drugs your child is taking and cause serious side effects. For example, one way the chemotherapeutic drug, Methotrexate, kills leukemic cells is by depleting them of folate. Multivitamins contain folate, and would interfere with your child's treatment.

School education during intense therapy

Your child may have missed out a lot of school for the first four to six months of treatment.

With the advice of your child's health care team, it may be possible to arrange special visits to your child's classroom during the early stages of your child's treatment. Teachers will often send homework, or perhaps a classmate or sibling could visit in the hospital with assignments. There are teachers in the hospital that can work with your child throughout their hospitalization.

Once your child reaches maintenance phase, they can go back to school on a regular schedule.

For more information, please see School and Leukemia.

Sun and bug protection

It is important for your child to take precautions about sun exposure. It is important that your child wear sunscreen anytime they are in the sun to protect against the sun's UVA and UVB rays.

Your child should also be protected from bug bites, which can be a source of infection.

Medication safety

You will be handling a lot of your child's medications at home. Be careful to keep them in a safe, locked space, protected from other children.

It is very important that your child take their medicines on time during their treatment. The pharmacist will provide you with a calendar to help you remember the time and days your child needs their medicines.

Partnering with your family physician

It is a good idea to maintain ties with your child's family doctor. They are still your child's primary care physician and you can still see them for routine concerns.

The Internet as a resource

While there are legitimate health websites that come from reliable sources, there is also a lot of unaccredited material on the web. Always be cautious of where you are getting your information from. Important questions to ask yourself:

  • Who funded this website?
  • Where and how are they getting their information?
  • Is it referenced?

It is best to ask your doctor any questions you may have while your child is being treated.

Last updated: March 6th 2018