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Leukemia and Infections: Prevention and When To Call Your Doctor

Posted on May 17, 2022
Medically reviewed by
Todd Gersten, M.D.
Article written by
Anastasia Climan

Having any type of cancer raises the risk of infection for multiple reasons. Infections may develop as a result of the cancer itself, poor nutrition, or the side effects of certain medications. Additionally, infections are often more dangerous for people living with cancer. That’s why it’s crucial for people with leukemia to be extra careful to avoid getting sick, especially when they’re undergoing treatment.

Frequent infections are a hallmark symptom of leukemia. Sometimes, frequent colds and other infections are the first symptoms people notice before they’re diagnosed with blood cancer. Leukemia and leukemia treatments also suppress the immune system, increasing the chance of bacterial, viral, and fungal infections. Here are some signs to watch out for and ways to help keep yourself or your loved one with leukemia safe.

Common Infections for Those With Leukemia

People with leukemia are prone to different types of infections, such as:

  • Pneumonia — Infection of the lungs
  • Colitis — Infection in the digestive system
  • Skin infections
  • Respiratory tract infections — Infection of the lungs, airways, or sinuses

Members of MyLeukemiaTeam have shared their struggles with infections. One member wrote, “I had the mother of all sinus infections since last week. I guess it’s due to my low immune system.” Another said, “I have a sinus infection, and it is going to be tough to beat it.”

Researchers have noted that between 10 percent and 15 percent of people with leukemia experience urinary tract infections (UTIs). Bacterial E. coli and fungal candida (yeast) infections are associated with the use of urinary catheters and stents.

Skin infections, such as cellulitis, may develop from phlebotomy or surgical incisions. In addition, blood infections arising from the intestinal tract can be caused by a range of bacteria, including Pseudomonas aeruginosa and Enterobacter species.

When To Be Extra Careful

If you’re undergoing chemotherapy for leukemia, you should be aware that the risk of infection is higher for a period after treatment.

The immune system’s white blood cells, which help keep you safe from germs, are often unintended casualties of chemo treatment that’s meant to kill cancerous cells. In addition to causing neutropenia (low white blood cell counts), chemo can damage mucosal barriers — the tissues in your digestive system that help protect against infections. Your oncologist will monitor your white blood cell levels during chemo and may prescribe antibiotics or growth factors (substances that promote growth of cells) to help prevent infections.

Stem cell or bone marrow transplants also make you highly vulnerable to infection. Before your procedure, your doctor should review these risks with you and discuss how you can protect yourself against pathogens. Ask your health care provider for tips, and make sure you have a clear understanding of the precautions you need to take when recovering from a stem cell transplant. Even if you feel well, you may need to remain extra careful for a year or more following your procedure.

Preventing Infections

Some people are at higher risk of getting sick because of their work or home environment. For example, those who work closely with children or in a health care setting tend to be exposed to pathogens more frequently. If you have additional health problems, such as diabetes or insomnia, you may also be predisposed to getting sick. Here are some steps you can take to reduce your risk.

Ask Your Doctor About Vaccinations

Certain vaccines are important for people living with leukemia. Experts recommend yearly flu shots for both people diagnosed with cancer and their loved ones. Additionally, getting vaccinated against pneumococcal pneumonia may be a good idea. The Leukemia & Lymphoma Society also recommends COVID-19 vaccination for most people with leukemia.

Ask your health care provider which vaccines can help protect your health.

Although vaccines are normally a recommended way to boost the immune system against infections, you may not be able to get specific vaccines if your white blood cell count is too low or your provider feels that your body won’t be able to handle receiving the vaccine.

For example, the vaccine against measles is actually a weakened, live sample of the disease. Depending on the status of your immune system, your doctor may advise you to hold off on receiving certain shots and stay away from others who were recently vaccinated.

Practice Good Hygiene

Basic hygiene can go a long way toward keeping you safe from infection. Tips include:

  • Avoid people who are sick.
  • Discuss recommendations for dental hygiene with your health care provider.
  • Don’t get new body piercings or tattoos at this time.
  • If you wear contact lenses, always use fresh cleaning solution.
  • Keep your towel and washcloth separate from others’ and only for your personal use.
  • Maintain short and clean nails.
  • Shower or bathe daily with a mild soap that doesn’t dry out your skin.
  • Wash your hands frequently with antibacterial soap (especially before eating).
  • Use an alcohol-based hand sanitizer when you’re unable to wash your hands.

Make Lifestyle Changes

Sleeping enough, managing stress, and eating a healthy diet can all play a role in optimizing your immune system. One of the reasons people with cancer are more likely to get an infection involves malnutrition. Your body may need extra calories and protein to recover after surgery or cancer treatments. Unfortunately, many cancer medications affect appetite, making food less appealing. A registered dietitian can give you ideas and strategies to ensure your immune system is supplied with the nutrition it needs.

If you have pets at home, you’ll need to be especially careful when caring for them. Have someone else clean up pet messes, and don’t allow animals to sleep in your bed. Wear gloves when handling pets such as birds, reptiles, and hamsters.

When To Call Your Doctor

People with leukemia or another condition that affects the immune system should contact their health care provider right away at any sign of infection. Even if treatment isn’t required, monitoring the situation early can prevent it from getting out of hand.

Signs of infection may include:

  • Chills
  • Diarrhea
  • Fever (temperature of 100.4 degrees Fahrenheit or more)
  • Painful urination
  • Redness, swelling, or tenderness near a wound
  • Sore throat or persistent coughing
  • White patches in the mouth or bleeding gums

Recovery

Members of MyLeukemiaTeam have discussed how they recover and move forward after an infection. One member shared: “Whenever I get an infection, I always go back to the doctor and make sure my WBC (white blood cell count) has come down and the infection is gone. Now, if I get a bad infection, I go to the emergency center and ask for an IV. It helps clear up the infection faster.”

An infection can feel like a major setback when you’re already facing leukemia and undergoing treatments. However, it’s important to keep in mind that infections are common. With the guidance and support of your health care team, you can get back on the route to recovery.

Talk With Others Who Understand

MyLeukemiaTeam is the social network for people with leukemia and their loved ones. Members come together to ask questions, give advice, and share their stories with others who understand life with leukemia.

Have you ever experienced an infection during leukemia treatments? What sorts of precautions do you take to avoid getting sick? Share your experience in the comments below, or start a conversation by posting on your Activities page.

All updates must be accompanied by text or a picture.
Todd Gersten, M.D. is a hematologist-oncologist at the Florida Cancer Specialists & Research Institute in Wellington, Florida. Review provided by VeriMed Healthcare Network. Learn more about him here.
Anastasia Climan is a dietitian with over 10 years of experience in public health and medical writing. Learn more about her here.

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