Peripheral neuropathy is a rare complication of chronic lymphocytic leukemia. It may also be a side effect of certain cancer treatments, such as chemotherapy.
Chronic lymphocytic leukemia (CLL) makes up
The most common complications of CLL include infections (prolonged or frequent), anemia, or thrombocytopenia. Peripheral neuropathy (PN) is a very rare manifestation of CLL.
Keep reading to learn more about PN and other complications associated with CLL.
What is peripheral neuropathy?
PN is caused by damage to your peripheral nerves, which carry messages both to and from your brain and spinal cord. Symptoms depend on the exact type of peripheral nerves involved, but may include:
- sensations of numbness, tingling, or “pins and needles”
- discomfort or pain
- muscle weakness
- muscle cramps
- severe pain from only the lightest of touches, called allodynia
- heat intolerance or cold intolerance
- difficulty regulating blood pressure, which can lead to dizziness or fainting, especially when standing up
- urinary incontinence
- digestive symptoms like constipation or bowel incontinence
- trouble with walking, balance, or coordination
Generally speaking, PN is uncommon in people with CLL. For example, in a
It’s also unlikely that CLL itself leads to PN. In very rare cases, leukemia cells can get into peripheral nerves, leading to PN. This is called neuroleukemiosis and happens in only 1% of people with any kind of leukemia.
Cancer treatments
In many situations, PN can develop due to one or a combination of other causes, such as treatments for cancer, especially chemotherapy. The
Certain CLL treatments carry potential side effects of PN. These include:
- BTK inhibitors (up to 10%)
- Rituxan (rituximab)
- Fludarabine
- Cyclophosphamide
- Treanda (bendamustine)
Other contributing factors
Other factors that may contribute to PN in people with CLL include:
- preexisting health conditions that are associated with PN, such as type 2 diabetes
- certain infections, such as shingles, which is prevalent in people with CLL due to low blood counts
- autoimmune activity
- vitamin deficiencies
CLL can lead to a variety of other complications. These include:
- low blood cell counts, which can lead to:
- autoimmune cytopenia, which is when your body makes antibodies that target healthy blood cells
- Richter transformation, an aggressive form of lymphoma, or prolymphocytic leukemia
- transformation into acute types of leukemia like acute lymphocytic leukemia (ALL) or acute myeloid leukemia (AML)
- second cancers, including but not limited to:
- skin cancers, particularly melanoma
- lung cancer
- gastrointestinal cancers
- Kaposi sarcoma
- head and neck cancers
- other types of blood cancer, such as AML or lymphoma
The treatment of PN can depend on which types of peripheral nerves are affected. Some of the potential treatments that a doctor might recommend include:
- medications, such as certain antidepressants or seizure medications, to help ease discomfort or pain due to PN
- topical numbing creams or patches that can be applied directly to an affected area
- transcutaneous electrical nerve stimulation (TENS), which can help relieve pain by delivering an electrical current to the affected area via small electrodes
- physical or occupational therapy to work on your motor skills, strength, and balance
- assistive devices, such as canes or grab bars, to aid you in moving around safely
- psychotherapy to help you to better cope with your symptoms
- complementary therapies, such as acupuncture or massage, to help ease symptoms
PN can happen as a complication of some cancers. While it can occur in some individuals with CLL, it is not very common.
Some possible causes of PN in people with CLL can include things like the side effects of treatment, some preexisting health conditions, and certain infections. In some people, multiple factors may contribute.
CLL is also associated with a variety of complications like low blood cell counts and transformation into more aggressive cancers.
If you’ve recently received a CLL diagnosis, be sure to ask your healthcare team about potential complications, their symptoms, and how to address them if they occur.