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Pediatric Chemotherapy

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Chemotherapy is the use of anticancer drugs to treat cancer cells. Chemotherapy has been used for many years and is one of the most common treatments for cancer. In most cases, chemotherapy works by interfering with the cancer cell's ability to grow or reproduce. Different groups of drugs work in different ways to fight cancer cells. Chemotherapy may be used alone for some types of cancer or in combination with other treatments, such as radiation or surgery. Often, a combination of chemotherapy drugs is used to fight a specific cancer. Certain chemotherapy drugs may be given in a specific order depending on the type of cancer it's being used to treat.

While chemotherapy can be quite effective in treating certain cancers, chemotherapy drugs reach all parts of the body, not just the cancer cells. Because of this, there may be many side effects during treatment. Being able to anticipate these side effects can help you and your child prepare and, in some cases, prevent these symptoms from occurring.

How is chemotherapy administered?

Chemotherapy can be given:

  • As a pill to swallow

  • As an injection into the muscle or fat tissue

  • Intravenously (directly to the bloodstream through a vein; also called IV)

  • Topically (applied to the skin)

  • Directly into a body cavity

What are some of the chemotherapy drugs and their potential side effects?

The following table lists some of the chemotherapy drugs commonly used in children and some of the side effects. However, each child may experience symptoms differently and at different times of the treatment. Some side effects may occur early on (days or weeks) and some side effects may occur later (months or years) after the chemotherapy has been given. The side effects listed aren't all the possible problems that may occur. Always consult your child's doctor if your child is feeling anything unusual.


Chemotherapy drug
 Side effects (short-term and long-term)
L-asparaginase, Elspar—usually given IV; also can be given as an injection
(a shot into muscle or skin)

  • Drowsiness can occur during and continue for several weeks after treatment

  • Nausea, vomiting, and cramping

  • Allergic reaction: rash or increased breathing effort 

  • Problems with blood clotting system (disseminated intravascular coagulation)

Busulfan, Myleran--usually given orally

  • Fatigue, tiredness

  • Decreased appetite

  • Hair loss (reversible)

  • Nausea and vomiting

  • Diarrhea

  • Decrease in blood cell counts

Carboplatin (Paraplatin)--usually given IV

  • Decrease in blood cell counts

  • Hair loss (reversible)

  • Dizziness

  • Darkened skin coloration

  • Ringing in ears and hearing loss

  • Kidney damage

Cisplatin (cisplatinum, Platinol, Platinol-AQ)--usually given IV

  • Decrease in blood cell counts

  • Allergic reaction: rash and increased breathing effort

  • Nausea and vomiting that usually occurs for about 24 hours

  • Ringing in ears and hearing loss

  • Fluctuations in blood electrolytes

  • Kidney damage

Cyclophosphamide (Cytoxan, Neosar)--can be given IV or orally (by mouth)

  • Nausea, vomiting, and abdominal pain

  • Decreased appetite

  • Sore mouth and taste changes

  • Diarrhea

  • Hair loss (reversible)

  • Bladder damage

Cytarabine (Ara-C, cytosine arabinoside, Cytosar-U)--usually given IV and/or intrathecally
(into the spinal column)

  • Nausea, vomiting, and diarrhea

  • Decreased appetite

  • Decrease in blood cell counts

  • Fever and flu-like symptoms

Daunorubicin (Cerubidine), doxorubicin (Adriamycin PFS, Adriamycin RDF, Rubex)--usually given IV

  • Nausea and vomiting

  • Hair loss (reversible)

  • Red colored urine (not bleeding but a drug effect)

  • Decrease in blood cell counts

Etoposide (VePesid, VP-16)--may be given orally or IV, teniposide (Vumon)--usually given IV

  • Nausea and vomiting

  • Hair loss (reversible)

  • Decrease in blood cell counts

  • Low blood pressure

  • Decreased appetite

  • Diarrhea

Hydroxyurea (Hydrea)--usually given orally

  • Decrease in blood cell counts

  • Nausea and vomiting

  • Diarrhea

Mercaptopurine (6-MP, Purinethol)--usually given orally

  • Nausea and vomiting

  • Decreased appetite

  • Tiredness and weakness

  • Decrease in blood cell counts

Methotrexate (MTX)--may be given IV, intrathecally (into the spinal column), or orally (by mouth)

  • Nausea and vomiting

  • Decrease in blood cell counts

  • Diarrhea

  • Skin rashes

  • Dizziness, headache, or drowsiness

Thioguanine (6-TG)--usually given orally

  • Nausea and vomiting

  • Diarrhea

  • Decreased appetite

  • Decrease in blood cell counts (after several weeks)

Thiotepa (Thioplex, Tepa)--usually given IV, intrathecally (directly into the spinal column), may be instilled in bladder, or injected into the tumor

  • Loss of appetite

  • Nausea and vomiting

  • Hair loss (reversible)

  • Decrease in blood cell counts

  • Temporary or permanent sterility (inability to have children)

Topotecan (Hycamtin)--given IV

  • Muscle achiness

  • Nausea and vomiting

Vincristine (Oncovin)--usually given IV, vinblastine (Velban, Velbe)--usually given IV

  • Weakness

  • Loss of reflexes

  • Nausea and vomiting

  • Hair loss (reversible)

  • Diarrhea or constipation, abdominal cramping

  • Decrease in blood cell counts




Applicable Conditions Children's Team Our Stories Departments
Applicable Conditions

Applicable Conditions

Acute Lymphoblastic Leukemia (ALL)

Learn more about acute lymphoblastic leukemia, including its symptoms, what causes and how we treat it.

Retinoblastoma

Retinoblastoma is a rare cancer of the retina (the innermost layer of the eye, located at the back of the eye, that receives light and images necessary for vision).

Leukemia

Leukemia is the most common form of pediatric cancer. It affects approximately 3,250 children each year in the US, accounting for about 30 percent of childhood cancers. It can occur at any age, although it is most commonly seen in children between 2 and 6 years of age.

Rhabdomyosarcoma

Rhabdomyosarcoma is a cancerous tumor that originates in the soft tissues of the body, including the muscles, tendons, and connective tissues.

Soft Tissue Sarcoma

Soft tissue sarcoma is a type of cancer that grows in soft tissues that support and connect parts of the body.

Neuroblastoma

Pediatric neuroblastoma is a cancerous tumor that begins in nerve tissue of infants and very young children.

Brain Tumors

Brain tumors are the most common solid tumors in children.

Germ Cell Tumors

Germ cell tumors are malignant (cancerous) or nonmalignant (benign, noncancerous) tumors that are comprised mostly of germ cells.

Non-Hodgkin Lymphoma

NHL is cancer in the lymphatic system. The lymphatic system is part of the immune system and functions to fight disease and infections.

Nasopharyngeal Carcinoma

Our cancer team specializes in treating rare cancers like nasopharyngeal carcinoma. Learn more about its causes and treatments

Children's Team

Children's Team

Providers

Jeffrey Dome

Jeffrey Dome

Vice President, Center for Cancer and Blood Disorders
Division Chief, Oncology
Associate Director, Center for Cancer and Immunology Research
Brian Rood

Brian Rood

Director, Clinical Neuro-Oncology
Medical Director, Brain Tumor Institute
Oncologist
Our Stories

Our Stories

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Chris's Story

When Chris's parents noticed he had lingering pain and swollen lymph nodes, they knew it was time to take him to the doctor.

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Christopher's Story

Christopher Melkonian was six years old when he came down with a low-grade fever and diffuse bone pain. Unsure of what was happening, his parents Darlene and David took him to Children’s National Health System and soon found out that Christopher had acute lymphoblastic leukemia (ALL), a type of blood and bone marrow cancer that affects white blood cells.

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Amira's Story

Despite the past decade spent in and out of the hospital, Amira has her sights set on a bright future and doesn’t allow her diagnosis to define who she is.

Departments

Departments

Leukemia Lymphoma Program

We deliver comprehensive care for all blood cancers including chemotherapy, bone marrow transplant and experimental therapeutics.

Bone Health Program

Orthopaedists at Children’s National offer world-renowned expertise and life-changing care, including surgery, for children at high risk for bone fracture.

Oncology

Our oncology (cancer) team provides personalized treatment plans for children with cancer, including access to clinical trials.

Solid Tumor Program

Our Solid Tumor Program has a dedicated team of sarcoma experts who specialize in the newest treatments and clinical trials.

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