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Chronic lymphocytic leukemia is a type of cancer that leaves you immunocompromised. This can increase your risk of cancers and autoimmune conditions. Taking steps to boost immunity can help you stay well.

Your bone marrow plays an important role in your body. It produces versatile stem cells that become specific types of blood cells. Red blood cells transport oxygen throughout your body, platelets stop bleeding, and white blood cells fight infection to keep you healthy.

Chronic lymphocytic leukemia (CLL) is a type of cancer that starts in your bone marrow. CLL changes your infection-fighting white blood cells and interferes with how they work. As a result, CLL weakens your immune system.

Read on for more information and tips on how to manage being immunocompromised when you have CLL.

There are several types of white blood cells, but lymphocytes are the ones primarily involved in CLL.

Healthy lymphocytes protect you against viral, bacterial, and fungal infections that can make you sick. When you have CLL, your body produces abnormal lymphocytes called leukemia cells, which don’t fight infection as well as lymphocytes do.

With CLL, your bone marrow still produces healthy white blood cells, but the leukemia cells multiply faster and live longer than the healthy ones. As they reproduce, these leukemia cells take over space in your bone marrow, leaving less room for healthy white blood cells.

Because the leukemia cells don’t fight infection well, your immunity decreases as their numbers increase.

If you have a condition that weakens your immune system, such as CLL, you have a higher chance of developing the following conditions:

  • Infections: People with CLL are more vulnerable to respiratory infections such as pneumonia, as well as infections of the skin, soft tissue, and urinary tract. This is due to both the condition itself and some of its immune-suppressing treatments.
  • Richter’s syndrome: Also known as Richter’s transformation, this rare complication of CLL can transform the condition into other types of lymphoma that are harder to treat.
  • Other cancers: Cancers of the skin, larynx, lung, and colon are some of the more common secondary cancer diagnoses that may accompany CLL.

Up to 25 percent of people with CLL experience autoimmune complications. An autoimmune reaction happens when your immune system mistakenly attacks your body’s healthy cells.

Most of the autoimmune complications that can occur in CLL involve your immune system attacking blood cells. This is called autoimmune cytopenia (AIC), and it can happen in several ways:

  • Autoimmune hemolytic anemia: Your immune system destroys red blood cells faster than your body can produce them.
  • Immune thrombocytopenia: Your immune system attacks your platelets (clotting cells), resulting in a shortage.
  • Pure red blood cell aplasia: Your bone marrow doesn’t make enough red blood cells, likely due to an autoimmune attack. (This occurs less frequently in CLL than other types of AIC do.)

You can make certain changes to avoid possible sources of infection and boost your overall health — and, in turn, better manage CLL.

Here are some ways you can reduce your risk of infection:

  • Wash your hands thoroughly and often.
  • Avoid or reduce contact with people who have contagious conditions such as colds, the flu, and COVID-19.
  • Ask your doctor about vaccines you should get, such as those for flu and pneumonia (people with CLL should avoid live vaccines that are given via a nasal spray).
  • Avoid eating foods that may contain harmful bacteria, such as uncooked fish and meat.

Here are some habits that can help you boost your overall health:

  • Eat a balanced diet that includes plenty of nutrient-dense foods such as fruits and vegetables. Just make sure to properly wash fruits and vegetables. Avoid highly processed foods as much as possible.
  • Get regular physical activity to boost your energy levels and stay fit.
  • If you smoke, talk with your doctor about effective strategies for quitting.
  • Try stress-reduction activities such as meditation or a fun hobby.

If you have CLL, you may have concerns about COVID-19.

People with CLL may have some factors that increase the chance of a more severe case of COVID-19, such as older age and a suppressed immune system. Those receiving cancer treatment such as chemotherapy also have an increased risk of complications from the virus.

Protective measures such as mask-wearing, handwashing, and physical distancing can help reduce your risk. Your treatment plan will depend on your individual case of CLL and potential exposure status.

If you haven’t yet started treatment and there’s a spike in COVID-19 cases in your area, your doctor may suggest waiting to start treatment. This can help minimize your potential exposure to the virus and the immunosuppressive effects of CLL medications.

It’s important to work with your doctor to develop a plan for monitoring your condition while you wait for treatment.

If you don’t qualify for a “watch and wait” approach to CLL treatment, your doctor will typically recommend systemic treatments that require fewer in-person visits to administer and have less of an immunosuppressive effect.

If you’re receiving CLL treatment and develop mild COVID-19 symptoms, your doctor may instruct you to get tested for the virus and monitor your symptoms. With mild symptoms, you may be able to stick with your CLL treatment as directed. If you test positive for the SARS-CoV-2 virus, your doctor may recommend pausing some medications until you’ve recovered.

Getting vaccinated against COVID-19 may be a good idea if you have CLL. But before you sign up for a vaccine, it’s important to talk with your doctor about your individual case and any other health conditions you have.

Leukemia cells don’t always stay in your bones. They may leave your bone marrow and enter your bloodstream, where they can build up in organs and cause complications. Possible related health complications include:

  • weakened immune system
  • low blood cell counts
  • enlarged lymph nodes
  • infections, such as pneumonia
  • pulmonary embolism (a blood clot in your lungs)
  • pleural effusion (fluid around your lungs)
  • damage to your alveoli (lung air sacs)
  • Richter’s transformation
  • AIC
  • other types of cancer

CLL is a type of cancer that starts in your bone marrow and damages white blood cells, decreasing your immunity. CLL can increase your risk for infections, other cancers, autoimmune reactions that destroy blood cells, and severe complications related to COVID-19.

If you have CLL, you can take steps to stay healthy by avoiding close contact with people who are sick, washing your hands frequently, and staying up to date on vaccines. Healthy lifestyle habits such as eating a nutritious diet, exercising regularly, and getting enough sleep can also help boost your overall health.