Anemia

[Winsey]

I've had CLL for 3 yrs. with a W/W for now. I also have reflux and been taking PPI's for years, now my blood work says anemia. I know prolonged use of PPI's can cause anemia, I'm wondering if it's that or my CCL? Has anyone out there experienced this?

Thanks, Winsey

[Cllcanada Top Poster CURE Hero]

You need to be tested for B12 and intrinsic factor to rule out pernicious anemia first.

CLL related anemia, aka a cytopenia is a complication of the disease that is not uncommon.

Get your doctor on your case and he can do some sleuthing...

~chris

[Winsey in reply to Cllcanada]

Thank you so much for your prompt reply. I did have 2 additional blood tests done but don't know exactly what they were. I have asked that my test results be given to me, via my patient portal. I see the PA next wk. and my oncologist is to be included in the test results, I'll keep you posted.

[LoganS in reply to Cllcanada]

Thanks Chris, what is cytopenia? No dic. Difinition. I also am borderline anemia.

[Cllcanada Top Poster CURE Hero in reply to LoganS]

Cytopenia is a reduction in the number of mature blood cells. It takes a number of forms: Low red blood cell count: resulting in anemia. Low white blood cell count: leukopenia or neutropenia. Because neutrophils make up at least half of all white cells, they are almost always low in leukopenia.

[shazie]

I suggest to check your Ferritin. You may need to take iron supplement like me. I have been on Nexium for years so is my prescribing physician.

[DaleFL in reply to shazie]

On a different matter, consider asking your doctor to text for magnesium. PPIs, such as Nexium, can cause a magnesium deficiency in some people. I take Nexium daily, and my doctor checks my magnesium at least once a year, along with B12, Folic Acid, and iron panel (including ferritin, iron, TIBC), and Vit D.

[shazie in reply to DaleFL]

Great suggestion. I do check my magnesium as well. I check it every other month

[Winsey in reply to shazie]

Thank you, I'll have it checked. Winsey

[Elliot43]

Hi Winsey. I've been on PPIs for a long time too... Pariet. I have a hiatus hernia. It hasn't had any effect on my HG. I have only been neutropenic whilst on FCR treatment.

Sheila in oz

[Winsey]

Thanks , I should know more on Tues. at my Dr's appt. I will ask for copies of my blood work.

Be well, Winsey

[Quarry]

I have no idea what PPIs are! But CLL cells can trick your white cells into thinking your red blood cells are the enemy and so go about destroying them - this is known as Auto Immune Haemolytic Anaemia(AIHA). You can get this even if your CLL is low level and nowhere near needing treatment. So you need to ask your doc on what is causing your anaemia (AIHA indications can be seen in wider-than-standard blood tests).

[Newdawn Administrator in reply to Quarry]

This explains PPI’s (Proton Pump Inhibitors);

medicinenet.com/proton-pump...

Newdawn

[Cllcanada Top Poster CURE Hero in reply to Newdawn]

I find it odd that CLL patients aren't routinely checked for H.pylori, which can contribute later to thrombocytopenia, low platelets, and lead to MALT.

Easy to test for, quite easy to treat...

ncbi.nlm.nih.gov/pmc/articl...

Cleared up my 5 years of gut issues in a month.. they have never returned...

~chris

[Winsey in reply to Cllcanada]

Great question, and fairly easy fix. Thanks, Winsey

[Winsey in reply to Newdawn]

Thank you Newdawn

[Winsey in reply to Quarry]

Hi PPI's are proton pump inhibitors for reflux . I also have autoimmune disorder.

Thanks, Winsey

[Newdawn Administrator in reply to Winsey]

Yes they are used for acid reflux Winsey.

Regards,

Newdawn

[MsChief in reply to Quarry]

PPI stands for proton pump inhibitors which is a class of medication prescribed for people with GERD which stands for gastric-intestinal reflux disorder. I just had an endoscopy and colonoscopy. The GI MD SAID I should take pantoprazole 40mg every morning rather than tha occasional Zantac 75 -150mg I take. Pantoprazole is Protonix. I am thinking about it considering the long term side effects of these drugs. Carole in the U.S.

[AussieNeil Partner Administrator in reply to MsChief]

I've been taking Omeprazole for nearly 9 years to prevent acid reflux causing scarring and another case of esophageal stricture. A couple of years ago, my B12 serum levels (essential for red blood cell formation) checked out OK, though my anaemia from CLL was progressing at the time.

If we regularly have reflux symptoms, we need to be aware of our increased risk of esophageal cancer. From webmd.com/heartburn-gerd/gu...

'About 5% to 10% of people with GERD develop this condition (Barrett’s esophagus), where stomach acid causes precancerous changes in cells.

The good news is that only 1% of people with Barrett’s esophagus will get esophageal cancer.'

That 1% of 5 to 10% is probably higher with CLL, due to our higher risk of secondary cancers...

Here's a trial report comparing short term effectiveness of Pantoprazole vs Omeprazole:

ncbi.nlm.nih.gov/pubmed/776...

Neil

[Winsey in reply to AussieNeil]

Thank you for the very useful information. Winsey

[Newdawn Administrator]

This is an excellent explanation of anaemia and it’s causes Winsey. The tests you’ve had should uncover the reasons for yours;

mayoclinic.org/diseases-con...

Newdawn

[Winsey]

Many thanks Newdawn. Be well, Winsey

[scarletnoir]

I have written about my own experience of anaemia before - it is in the thread labelled 'Anemia & CLL', showing on the right under Related Posts. ( healthunlocked.com/cllsuppo... - Admin)

In short, though, I started taking omeprazole (a PPI) at least 10 years before getting CLL. Even after BR chemo, I wasn't anaemic at first... but became so after 3 years or so post-treatment. My haematologist prescribed B12 supplement and ferrous sulphate, and that fixed the problem. I am still taking omperazole to prevent acid reflux.

[Cindy1462]

I wonder how many CLLrs have acid reflux? From this post it seems to be quite a few. Could there be a connection? I take Ranatadine instead of a PPI for mine. I have a sliding hiatus hernia which was diagnosed a year before my CLL.

[Winsey in reply to Cindy1462]

Hi Cindy,

That is a good question. I take Dexilant and Ranitidine, and will be having a colonoscopy to find out why my hemoglobin is low.