Pediatric Chemotherapy

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

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 Drugs and Short-Term and Long-Term Side Effects:

• 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