What are the side effects of high-dose chemotherapy? 

High-dose chemotherapy is a strong treatment used for some children with high-risk neuroblastoma. It can be tough on the body and may cause several side effects. Your child’s medical team will monitor them closely and support you throughout treatment. 

Common side effects 

These include:

• infections: After chemotherapy, it can take several weeks for blood counts to recover. During this time, children are more likely to get infections. The team will monitor for signs and may give antibiotics or anti-fungal medicines to help prevent or treat infections. 

• sore mouth and throat (mucositis): Painful sores can develop in the mouth, making eating, swallowing, and talking difficult. Mouthwashes, pain relief, and nutritional support can help manage these symptoms. 

• digestive tract soreness (mucositis): Ulcers and soreness can affect the digestive tract, causing discomfort and problems with eating. Nutritional support may be needed. 

• tiredness and feeling unwell: Children often feel very tired and generally unwell during and after treatment. Rest and gentle activities can help. 

• nausea and vomiting or diarrhoea: These are common but can usually be managed with medicines. 

Rare but serious complications

• Veno‑occlusive disease (VOD): Veno‑occlusive disease is a rare but serious liver problem that can occur after high‑dose chemotherapy. Your child’s medical team will monitor closely for early signs and can treat it quickly if it occurs. 

Long-term side effects

Doctors are still learning about the longer‑term effects of high‑dose chemotherapy. Not all children experience late effects, and the likelihood varies depending on factors such as your child’s age, the medicines and doses used, and their overall treatment pathway. 

In some cases, longer‑term effects can include problems with growth, learning, or how certain organs work. Your child will have regular long‑term follow‑up, so that any late effects can be identified early and managed with the right support. 

Managing side effects

Your child’s medical team will provide medicines, blood transfusions, and nutritional support as needed. 

If you notice anything unusual or are worried about your child, contact your child’s doctor or nurse straight away.