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Infection risk and neutropenia

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Understanding infection

Because blood cancer affects the body’s immune system, people with blood cancer can be at greater risk of infection.

What is infection?

Infections are caused by tiny living things (organisms) such as bacteria, viruses and fungi. Some of these can live inside your body without causing any problems and can even be good for your health. But others can be harmful, and if your immune system isn’t able to fight them off, you may become very ill.

People with blood cancer are at greater risk of getting an infection because their immune system may not be working as well as normal. This can be because of the cancer itself or as a result of treatment.

If an infection is left untreated it may end up causing serious health problems, and some infections can be life-threatening.

Don't wait to get help

If your immune system is weak, you’ll need immediate medical advice if you think you have an infection. Ask your healthcare team who to contact and keep a note of it to hand. See further down for what symptoms of infection to look out for.

How does my body fight infection?

Your immune system is a network of cells, tissues and organs which protects your body against infection. Your white blood cells play an important role in this. The white blood cells which fight infections are called lymphocytes and neutrophils. If you have low levels of white blood cells, your body will find it much harder to fight off infections.

Common types of infection are:

Bacteria are the most common cause of infection for people with blood cancer and can cause fever and blood poisoning (septicaemia).

Viruses are tiny infectious particles that invade and multiply in living cells such as cells in the human body. Viruses can cause diseases like colds, flu, and coronavirus (covid-19).

Fungal infections such as thrush (candidiasis) are rarely serious, but can cause problems if your immune system isn’t working properly.

Who is at risk of infection?

Having blood cancer can weaken your immune system and increase your risk of infection. Some blood cancer treatments can have the same effect, although this is usually only temporary.

Chemotherapy, radiotherapy, stem cell transplants, immunotherapy and steroids can all affect your immune system. Having an operation or treatment that involves puncturing the skin (including some dental treatment) also increases the risk of infection.

It’s very important to attend your follow-up appointments after treatment for blood cancer, so your doctors and nurses can check-up on your general health. It’s also important to be aware of the symptoms of an infection and contact your healthcare team if you think you have any of them.

Symptoms of infection

There are some signs of infection that you should watch out for. It’s important to remember that not everyone will get all, or even any, of the symptoms listed − everyone is different.

Symptoms of infection can include:

  • fever (a temperature of 37.5°C or above)
  • low temperature (less than 36°C)
  • shivering and sweating
  • feeling confused
  • sore throat and cough
  • rashes and swelling
  • frequent watery poos (diarrhoea)
  • a burning or stinging sensation when weeing, or trouble weeing at all
  • unusual stiffness of the neck
  • achy flu-like symptoms
  • fluid with an unusual smell, colour or texture coming from your vagina (discharge), or itching in or around your vagina
  • generally not feeling well

If you have any symptoms of infection, you should contact your medical team immediately, no matter how minor or vague the symptoms seem.

Treating infection

You may be given antibiotics, a type of medicine that kills bacteria. Antibiotics can be given as pills, as a liquid, or, for more serious cases, through a vein (intravenously).

Anti-viral medicines are sometimes used to treat viruses. They can be given as tablets, as a liquid, as a cream or through a vein.

Anti-fungal treatments may be given as tablets, as a liquid, as a cream or through a vein.


There are vaccinations which can help protect you from infections and illnesses such as flu and coronavirus.

If you’ve had chemotherapy (particularly combined with a drug called rituximab), then vaccinations might not work as well as usual, but may still offer some protection.

If you’ve had a stem cell transplant, you may need to repeat the vaccinations you had as a child, but you shouldn’t have live vaccines such as MMR until your healthcare team says it’s safe.

There may be certain vaccinations you shouldn’t have at all. Your healthcare team will tell you which vaccinations you should have and when. Contact your clinical nurse specialist (CNS) if you’re unsure.

We have information on getting the coronavirus vaccination if you have blood cancer, or are a household contact of someone with blood cancer. We also have information about how we’re funding research to find out how effective the coronavirus vaccination is for people with blood cancer.

Next, find out more about avoiding infections and managing your risk.

Telling other people about your infection risk

As lockdown eases and people get used to going out more, you may need to remind your family, friends or employer about your infection risk and explain why you need to take extra care. You might find it helpful to share our fact sheet about infection.

Supportive care

Supportive care means treatment that’s given to reduce the side effects of cancer treatment and help with the symptoms of blood cancer. This might include growth factors (G-CSF), which may be given with chemotherapy to help your bone marrow make new white blood cells and boost your immune system.

You may also be given anti-viral medication or antibiotics to prevent an infection. The medical name for this is prophylaxis.

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