When too many hematopoietic stem cells die, the body is no longer able to make new blood cells (red blood cells, platelets, neutrophils etc). Patients may become transfusion dependent, just to stay alive.  Aggressive chemotherapy may cause this type of pancytopenia, especially in elderly patients.

It is generally accepted that cancerous stem cells can be at the root of several blood cancers.  But while the concept has been kicked around, there has not been formal consensus that there could be a malignant stem cell at the root of CLL in particular.  That may be changing.  And it has implications for therapy options.

Red blood cell growth factors (trade names Aranesp, Procrit, Epogen etc) are quite popular with CLL patients.  But the latest guidelines regarding their use suggest caution.  Notwithstanding consumer-targeted advertisements, you need to understand the risks involved in using these drugs.

One of the crucial organs that can be infiltrated and damaged by CLL cells  is your liver. It is time you learnt about this very important organ.  If your liver shuts down, that can kill you a lot more quickly than CLL can.

Rituxan is part of most chemo combinations. Some protocols use Rituxan maintenance therapy as a way of prolonging remissions.  You should also be aware of the downside risks of this approach.

A small percentage of CLL patients develop myelodysplastic syndrome (myeloid cancer precursor) and some of these guys go on to develop full fledged myeloid cancer. In this article we discuss risk factors and chemotherapy drugs that may increase your chances of myelodysplasia.

Neutropenia is a frequent complication for CLL patients, especially during and after chemotherapy.  Risk of severe and possibly life threatening bacterial infection goes up with severe neutropenia.  There are things you can do to better protect yourself.

Rai and Binet systems have been the bedrock of staging risk status in CLL.  This important ASH2009 paper explains where both of these staging systems fail in predicting specific high risk groups.

This article is second in the series about CBC results.  We will discuss red blood cell parameters, what can go wrong, symptoms when things aren’t quite right, what can be done to improve them, your therapy options.

CBC is probably the single most ordered blood test.  Here is the first of a series of articles that will help you interpret the numbers on your latest CBC, what they mean and when to get excited. In this article the focus is on white blood cells.