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Late Effects of Treatment for Childhood Cancer (PDQ®)

  • Last Modified: 04/17/2014

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Immune System



Surgery to remove the spleen increases the risk of immune system late effects.

The risk of health problems that affect the immune system increases after treatment with the following:

Late effects that affect the immune system may cause infection.

Late effects that affect the immune system may increase the risk of very serious bacterial infections. This risk is higher in younger children than in older children and may be greater in the early years after the spleen stops working or is removed by surgery. These signs and symptoms may be caused by infection:

  • Redness, swelling, or warmth of a part of the body.
  • Pain that is in one part of the body, such as the eye, ear, or throat.
  • Fever.

An infection may cause other symptoms that depend on the part of the body affected. For example, a lung infection may cause a cough and thick mucus.

Children who have had their spleen removed may need antibiotics to prevent infection.

Taking daily antibiotics may be recommended for children younger than 5 years of age whose spleen is no longer working or for at least 1 year after surgery to remove the spleen. For certain high-risk patients, daily antibiotics may be prescribed throughout childhood and into adulthood.

In addition, children at risk should be vaccinated on a schedule through adolescence against the following:

  • Pneumococcal disease.
  • Meningococcal disease.
  • Haemophilus influenzae type b (Hib) disease.

Talk to your child's doctor about whether other childhood vaccinations need to be repeated.