How Are Steroids Used in Blood Cancer Treatment?

People living with blood cancer may receive corticosteroids (sometimes referred to as steroids) as part of their treatment plan. In this article, you will learn how corticosteroids work, how they are used alongside blood cancer treatments, and important safety considerations. 

What corticosteroids are and how they work in the body

Corticosteroids like prednisone and dexamethasone are treatments designed to mimic hormones naturally produced by the adrenal glands, which sit above the kidneys. These hormones play important roles in the body's response to stress, inflammation, and immune system activity. 

Corticosteroids work through both "genomic" and "non-genomic" pathways: 

• Genomic effects: Once inside a cell, corticosteroids bind to receptors and move into the nucleus to change how certain genes are expressed. This mainly decreases the production of inflammatory molecules.
• Non-genomic effects: Corticosteroids can also act quickly at the cell membrane, blocking early stages of inflammation within minutes. 

Understanding this is important because it explains why corticosteroids can act both rapidly and over time to control treatment-related symptoms. 

Corticosteroids to support blood cancer treatments

Corticosteroids are used before or alongside cancer therapies. The benefits they provide include:

• Reducing allergic-like reactions
• Managing inflammation
• Decreasing nausea and vomiting
• Improving a poor appetite 

This supportive use helps patients tolerate their blood cancer treatment better and maintain a higher quality of life. 

Side effects and what patients should know

While corticosteroids are helpful, they also come with potential risks. Common side effects include:

• Increased risk of infections
• High blood sugar levels
• Mood changes (such as anxiety or irritability)
• Weight gain
• Bone loss over time

The risk of these effects often depends on the dose and how long the medicine is taken. For people with blood cancers, this means that careful monitoring by your healthcare team is necessary. Special consideration may also be needed during treatments like CAR T-cell therapy, where research suggests corticosteroids at high doses for long periods of time should be limited to maintain treatment effectiveness. 

Summary

Corticosteroids support blood cancer treatments by reducing inflammation and helping control immune responses. When given at the correct dose for the right amount of time, they can improve how well treatment is tolerated and symptoms are managed. Understanding their benefits and risks can help individuals and care teams make informed choices during the treatment process.

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Sources: 

• Corticosteroids
• Prognostic impact of corticosteroids on efficacy of chimeric antigen receptor T-cell therapy in large B-cell lymphoma