Complications arising from the therapy

• Tumour lysis syndrome — hyperkalaemia, hyperuricaemia and acute renal failure may follow rapid destruction of a large white cell mass

• Neutropenia and immune compromise with an increased risk of infection

• Thrombocytopenia leading to spontaneous bleeding, usually from intravascular catheter sites, skin, lung, gut and brain

• Lung fibrosis, e.g. following radiotherapy, bleomycin

• Myocardial failure, e.g. following mitozantrone

• Graft versus host disease (GVHD) — features include mucositis, hepatitis, jaundice, diarrhoea, abdominal pain, rash and pneumonitis

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