The most common side effects with Hycamtin (seen in more than 1 patient in 10) are neutropenia (too few of the white blood cells that fight infection), febrile neutropenia (neutropenia that causes fever), thrombocytopenia (low platelet counts), anaemia (low red blood cell counts), leucopenia (low white blood cell counts), nausea (feeling sick), vomiting and diarrhoea (all of which may be severe), constipation, abdominal (tummy) pain, mucositis (mouth sores), alopecia (hair loss), anorexia (loss of appetite, which may be severe), pyrexia (fever), asthenia (weakness) and fatigue (tiredness).