Blood cancer and its treatment can affect the bone marrow’s ability to produce adequate numbers of healthy blood cells. Your blood count (the number of white cells, platelets and red cells circulating in the blood) will generally fall within a week of having your treatment.

The point at which the white blood cell count is at its lowest is called the nadir.  Your treatment team may also tell you that you are neutropenic (which means you are low in an infection-fighting white cell known as a neutrophil). This is usually expected 10 to 14 days after having chemotherapy.

During this time, you have a weakened immune system and are more susceptible to infections, including viruses like COVID-19, influenza and the common cold.

While your white blood cell count is low you should take sensible precautions to help prevent your exposure to infection.

How do viruses like influenza, common colds and COVID-19 spread?

These viruses are transmitted through direct contact with respiratory droplets that occur through coughing or sneezing of an infected person in close proximity. It can also be contracted through touching contaminated surfaces.

How can I help prevent infection and illness?

People

• Avoid places where there are likely to be a lot of people such as shopping centres, public gatherings, cinemas, sporting events etc.
• Avoid contact with those who are already infected and/or contagious, for example people with colds, flu and chicken pox. These could be your friends and work colleagues but also your family members.
• If family or friends have recently travelled overseas ensure they’re free of any infection symptoms, or have completed any periods of self-isolation, before visiting them.
• Avoid the use of public transport. Our transport service may be able to help.

Hygiene

• Wash your hands often for 20 seconds with soap and water
• Use alcohol based hand sanitiser when soap and water can’t be used
• Avoid touching your eyes, nose and mouth
• Clean and disinfect surfaces you use often
• Clean and disinfect objects you use often such as mobile phones, tablets, keys and wallets

Lifestyle

• Get plenty of sleep.
• Be physically active, if safe to do so.
• Manage your stress.
• Drink plenty of fluids and eat nutritious food.

Food and drink

• Only eat foods that have been properly prepared, washed and cooked thoroughly.
• Avoid raw or under-cooked foods.
• Only eat and drink pasteurised juice or dairy products.
• Avoid sharing your food or utensils while eating.

Medical advice

• If you test positive for COVID-19, isolate and contact your treatment team/haematologist immediately.
• If you develop flu symptoms, contact your GP or treatment team, especially if your symptoms include a fever.
• As always, your best source of information is your treatment team or treatment centre who knows your medical history best. While you’re there, what else could you ask?

Vaccinations

Vaccinations, including for COVID-19 and the flu, can reduce your chance of getting infected and spreading viruses to other people.

Speak to your treatment team/haematologist about which vaccinations you can have and when.

If you’re planning a holiday abroad, check with your treatment team/haematologist first about what vaccinations you may need and should have.

When should I contact my treatment team?

It’s important you contact your treatment team or hospital for advice immediately (at any time of the day or night) if you are feeling very unwell, or if you experience any of the following:

• A temperature of 38°C or higher* (even if it returns to normal) and/or an episode of uncontrolled shivering (also called a rigor)
• Bleeding or bruising, for example blood in the urine and/or bowel motions; coughing up blood, bleeding gums or a persistent nosebleed
• Nausea or vomiting that is prolonged and prevents you from eating or drinking, or taking your normal medications
• Diarrhoea, stomach cramps or severe constipation
• Persistent coughing or shortness of breath
• The presence of a new rash, reddening and/or itching of the skin
• A persistent headache or blurred vision
• A new severe or persistent pain
• Persistent swelling, redness or pus anywhere on your body.

* A normal body temperature is between 36 and 37°C

How can I prevent the spread of infection?

Those who are living with or are having treatment for a blood cancer are more susceptible to infection.

If you’re not feeling well, you should avoid and limit contact with those with a blood cancer diagnosis.  If this is unavoidable you should take sensible precautions to help prevent the spread of infection.

Hand washing

One of the most effective infection-control methods is frequently washing hands with soap and water or alcohol-based hand sanitiser.

Wash your hands not only after you sneeze or cough but also after using the toilet and before you eat or prepare food.

Cover your cough

• Cough or sneeze into the crook of your elbow or a tissue
• Dispose properly of your tissue into the bin and wash your hands afterwards

Wearing a mask

Wearing a mask can help protect you and those around you.

To use a mask properly you should:

• wash or sanitise your hands before putting it on or taking it off
• make sure it covers your nose and mouth and fits snugly under your chin
• avoid touching the front of your mask while wearing or removing it
• keep it in place – don’t hang it around your neck or under your nose
• use a new single use mask each time
• wash and dry reusable masks after use and store in a clean dry place.

Be aware

There are many simple and easy practices that can reduce the likelihood of infection spread. Be aware of your body and any changes and refer to the list on when to contact your treatment team.

If you are a close contact of a COVID-19 positive case, it is advised you get tested as soon as possible.

Coronavirus COVID-19 information

Protect yourself and others from COVID-19 | Australian Government Department of Health

Blood cancer and COVID-19 – Leukaemia Foundation