CLL Complications

ITP: Immune Thrombocytopenia

Possible Connection to H. pylori

Platelets in Danger

Immune thrombocytopenia (ITP) is a serious complication of CLL that affects a small percentage of patients. It is a condition in which the immune system destroys platelets. Research suggests that a common pathogen, Helicobacter pylori, can sometimes be the cause of ITP and that controlling and eradicating this infection can resolve ITP in its early stage. We discuss this and other characteristics of this condition in ITP: Immune Thrombocytopenia. (12/6/07)

 

Infections: Who Is Most at Risk?

Prognostic Indicators Can Identify Infection Risk

Know Your Enemy

Serious infections account for an alarming proportion of deaths among CLL patients.  But are some patients more at risk than others?  What are the prognostic indicators which can help you assess the risk of serious infections in your own case? In Who Is Most at Risk? we review a very recent article that looks at the different risk buckets and provides some practical pointers to improve your chances of staying out of the hospital.

 

Super Bugs: Staph

MRSA Is on the Loose

The Dangers of Drug Resistant Bacterial Infections

Recent reports prove that infections from strains of drug-resistant bacteria are far more prevalent than previously thought, accounting for more than half of all skin infections treated in hospital emergency rooms. Infectious diseases experts are trying hard to get the word out. While this poses a serious threat to public health, CLL patients will do well to pay special attention to this phenomenon and take some precautions — so that they may avoid these difficult and persistent infections which their systems are ill-equipped to fight. Read about these super bugs in The Dangers of Drug Resistant Bacterial Infections.

 

EBV

The Kiss that Can Kill

The Enemy Within

The Epstein-Barr Virus (EBV) has long been known as a complicating factor in many cancers. Recent research has shown just how serious is the threat posed by this virus in CLL. EBV is estimated to be present in over 90% of adults in the western world, but is normally kept in dormancy by active T-cells. Read The Enemy Within to learn how EBV can interfere with normal T-cell function and how T-cell damaging therapy with agents such as fludarabine and Campath can unleash EBV with life-threatening consequences. We also discuss how patients may be able to use a common statin to improve their defenses against this virus.

 

Infectious Complications

Best Practices

How to Treat and Manage Infections in CLL

Infectious complications are the major cause of mortality in CLL and affect the quality of life of most patients. The best practices in managing infections have changed over time, tracking our knowledge of the molecular mechanisms at work and reflecting the nature of the therapies used to treat the CLL itself. In our article Infectious Complications of CLL, we review the latest expert findings. We also highlight the need for patients to be actively involved in discussing these best practices with their local oncologists, to ensure that they receive appropriate care.

 

Caution on EPO

The Dark Side of Epoetin - Getting Darker

Be Careful What You Ask For !

The results of a new meta study have been published in the Journal of the National Cancer Institute. The authors find additional reasons to question the usage of high doses of epoetin drugs to achieve "normal" levels of hemoglobin. Biases in earlier studies may have understated the problems. We present our review in The Dark Side of EPO - Getting Darker.

 

CLL Complications

Oral Mucositis Can Be Deadly

A Real Pain in the Mouth

Many CLL patients experience painful sores and infections in their mouths, especially when they go through chemotherapy. This incidence of 'oral mucositis' can have serious consequences to the quality of life and even survival of these patients. There may be a few things you can do to help yourself - read about them in A Real Pain in the Mouth.

 

AIHA: Auto-Immune Hemolytic Anemia

Important Insight

Causes and Mechanisms - and Strategies to Deal with It

AHIA affects a significant part of the CLL population, particularly those with advanced disease. Understanding the causes of the disorder is critical to dealing with it. In AIHA: Auto-Immune Hemolytic Anemia, we review the relevant research and make some suggestions.

 

Dying to Get a Tan?

The Danger of Squamous Cell Carcinoma in CLL Patients

Things You Can Do to Avoid SCC

If you have CLL, you have a much higher chance of getting squamous cell carcinoma (SCC), the second most common skin cancer. Further, CLL patients who contract this disease are more likely to have an aggressive form of the disease. We examine some of the possible mechanisms for the onset of this cancer and review a number of steps you can take to protect yourself including a few things you can discuss with your doctor that may help. Click here to read Dying to Get a Tan?

 

The Dark Side of Epoetin

Study Links EPO Drugs to Promotion of Angiogenesis, Tumor Growth and Shorter Survival

The Unanticipated Side Effects of Epoetin

A very recent study casts light on some negative aspects of epoetin therapy. In addition to the desired effect of a rapid increase in red blood cells and hemoglobin and an improvement in quality of life, these drugs have now been shown in a carefully designed study to promote significant angiogenesis and tumor growth. Our November 22 article, The Dark Side of Epoetin, gives you an overview of the research on this aspect of an important supporting therapy.

 

Thrombocytopenia

Introducing Neumega

A Growth Factor for Platelets

In this article, Neumega: Treatment of Thrombocytopenia, we discuss a growth factor for platelets.

 

Splenectomy

Need and Consequences

Surgical Techniques

A badly infiltrated spleen sometimes has to be removed so that the patient can survive. In Splenectomy, we discuss the circumstances in which this procedure may be applied, its consequences and the surgical techniques used.

 

Hypogammaglobulinemia

Immunoglobulins and Infections

IVIg Infusions

There is a direct link between susceptibility to infection and the level of immunoglobulins in a patient's body - which in turn is affected by CLL, a dysfunction of the immune system. In Hypogammaglobulinemia, we discuss the effects of low immunoglobulin levels and the use of intravenous immnoglobulin (IVIg) injections as a treatment for this condition.

 

Drug Induced Complications

Drug Interactions Can Be Complex

Keeping Track of Prescriptions

Prescription drugs are employed as therapy in a wide range of conditions. They can have multi-faceted effects and interact in unpredictable ways. They can also induce chronic and sometimes dangerous conditions in patients. In Prescription Drug Induced Complications, we examine some of the problems that can be precipitated by prescription drugs.

 

Secondary Cancers

CLL Predisposes Patients to Other Cancers

Mutagenic Therapies and Failure of Immune Surveillance

CLL patients have a much higher risk of being diagnosed with certain secondary cancers than the population in general. Our article titled Secondary Cancers takes a detailed look at this aspect of CLL.

 

Viruses and Viral Drivers

A Vicious Cycle

Dangerous Interaction between CLL and Viruses

For many CLL patients, a compromised immune system can permit the activation of long-dormant viruses, which in turn can result in a higher level of inflammation and a rapid escalation of the CLL tumor load. This risk is particularly high when immunosuppressive agents are used to treat the CLL: so much so that when certain agents like Campath are used to in the treatment, prophylactic antiviral medications are now routinely used. Read Viruses and Viral Drivers to learn about the cast of characters in the viral underworld and how the tenuous balance between the immune system and dormant viruses can be upset by the cancer or the therapies for it.

 

 

Hypercalcemia

A Life Threatening Condition

Date: 3/18/03

by Chaya Venkat

My thanks to a member who identified the following two useful and authoritative links to information on hypercalcemia.

The first, from the National Cancer Institute: http://www.meb.uni-bonn.de/cancer.gov/CDR0000062810.html;
and another with technical information and emergency treatment guidelines, provided by eMedicine.com (from Web MD): http://www.emedicine.com/emerg/topic260.htm. As usual, a casual search of the web for 'hypercalcemia" will lead to all manner of corporate sites, seeking to peddle their wares. I am sure you will approach those with your customary skepticism.

Both of the above are excellent sites from credible sources for getting a quick handle on calcium levels in your blood and what can happen if they get too high. 

A couple of actionable items that jump out from both sources:

• Drink plenty of water!!
• Try and get some exercise every day, just a walk around the block several times a day, if that is what you can manage. It would be great if you can also add some weight bearing exercises.
• Do not cut back on dietary calcium intake. The increase in calcium in your blood is caused by chemicals put out by the cancer cells that cause the calcium to be leached out of your bones. It also makes it harder for the body to absorb the necessary calcium from your diet, and the net result is weakened bones. The last thing you want is a nasty hip fracture or something like that, while you are trying to cope with CLL. This is also the basis of my strong negative reaction to high dose methylprednisone administration, especially if the patients are post menopausal women already at risk of osteoporosis.
• Getting your blood electrolytes measured is a simple and inexpensive test, something you should add to your routine monthly CBC monitoring. Perhaps not as frequently as your CBC, but I make sure my husband gets it done at least once a quarter. If your local oncologist does not see the need for it, print out some of the stuff in the above sites and revisit the topic. It really helps to be politely assertive in these matters. This is one simple way of keeping tabs on your blood calcium levels.
• As for coral calcium, please don't get me started on all that rubbish. I did catch a few minutes of an infomercial by "Dr". Barefoot the other day. What can I say, gullibility will kill you just as certainly as hypercalcemia. Not to mention it will deplete your bank account. I am sorry if this offends any of our members who are serious fans of Dr. Barefoot, but there it is. As a professional chemist, I can tell you for a fact that the absorption of "coral calcium" in your diet is no different than simple calcium tablets you can buy at the corner drugstore.