A most unfortunate consequence of being diagnosed with CLL, is that you also get an immediate and accompanying permanent diagnosis of being immune compromised. Unfortunately, the degree of immune compromise worsens over time and with treatment. It is more often infections that become fatal, rather than the CLL, that reduces our life expectancy.
To live well with CLL, you really need to learn more about how illnesses are transmitted so that you know how to protect yourself from your now higher risk of infections that can take you considerably longer to overcome.
As Steven Maltby's article below on how our immune systems learn points out, our very complex immune system is made up of two equally important parts: innate and adaptive immunity. CLL is primarily a disease of the adaptive immune system, because this is provided by our lymphocytes and CLL is a cancer of our B-lymphocytes. As A. D. Hamblin and T. J. Hamblin state in 'The immunodeficiency of chronic lymphocytic leukaemia', "The most obvious and well-known abnormality is hypogammaglobulinaemia, (low antibodies IgG, IgA and IgM to fight infections - Neil) which is present in up to 85% of patients. Serum immunoglobulin levels may be suppressed in other lymphoid malignancies, but in CLL the suppression is far greater."
Unfortunately, CLL also affects our innate immune system, particularly in the more advanced stages. As CLL infiltrates our bone marrow, we are less able to manufacture our other disease fighting white blood cells. The most important of these are our neutrophils (about 60% of all our white blood cells in healthy people) that are the first blood borne defenders against any pathogens trying to infect us. Consequently, we are at higher risk of neutropenia, particularly during treatment. That puts us at more risk of infection even from what we eat, so be prepared to change your diet if you develop neutropenia.
Interestingly, today in 'The Conversation", Steven Maltby, Post-doctoral Fellow in Immunology & Genetics, University of Newcastle, Australia talks about new research that might help us live better with our compromised immune systems - if we don't first find a cure for CLL!. "Rather that being stuck with the immune system we genetically inherit, research is showing that immune responses are shaped by life experiences. It provides hope that we can improve immunity and reduce disease through changes in lifestyle and our environment.":
Your Immune System Is Made, Not Born
(This Scientific American article referenced by Steven Maltby specifically discusses the profound influence of cytomegalovirus (CMV) on the immune systems. Unfortunately CMV is bad news if you have CLL.)
CLL, A cancer of the Immune System
Safe eating for poor immune function - beyond the neutropenic diet
The immunodeficiency of CLL by AD Hamblin and T J Hamblin (2008)
Photo: An egret and a black cormorant taking shelter amongst palm and she-oak (casuarina) tree foliage