Chronic lymphocytic leukemia (CLL) is a blood cancer. Like all types of leukemia, it affects your immune system and can leave you at risk of infectious disease. This includes serious lung infections such as pneumonia.

Although pneumonia isn’t caused by CLL, having CLL does make it harder for your body to prevent and fight the infection. CLL can also lead to a number of additional lung complications, such as fluid buildup and damage to the air sacs inside your lungs.

In this article, we take a look at how chronic lymphocytic leukemia increases your risk of pneumonia and other complications of the lungs.

Chronic lymphocytic leukemia (CLL) doesn’t directly cause pneumonia. However, CLL does affect how your immune system operates. It changes the way your body produces a type of immune cell called lymphocytes. This makes it harder for you to fight off infections, including pneumonia and other lung infections.

Additionally, it’s possible for CLL to spread to your lungs. It’s estimated that around 2 percent of people with CLL also develop lung cancer. In some cases, this lung cancer is a result of CLL that has spread, but in other cases, the lung cancer tumors are separate.

Lung infections can cause coughing and trouble breathing, even when they’re not pneumonia. And infections are not the only lung complication that CLL can lead to.

Other lung complications and respiratory difficulties sometimes experienced by people with CLL include:

  • Enlarged lymph nodes. When the lymph nodes between your lungs swell, it can irritate your airways and make it difficult to breathe.
  • Alveoli damage. Your alveoli are the air sacs inside your lungs. They can bleed as a result of the CLL itself or from the medication you take to manage CLL.
  • Pulmonary embolism. A pulmonary embolism is a blockage in one of the blood vessels in your lungs. It’s normally caused by a blood clot.
  • Pulmonary leukostasis. A buildup of leukemia cells inside the blood vessels of your lungs is called pulmonary leukostasis. It can block the blood flow to your lungs.
  • Pleural effusion. A pleural effusion is the buildup of fluid around your lungs. It causes pain and shortness of breath. It can lead to a partial or even total lung collapse.

The symptoms of pneumonia and other lung-related complications of CLL can be very similar. These symptoms of lung-related complications are discussed below.

Pneumonia symptoms

Common symptoms of pneumonia include:

  • a cough
  • a cough that produces mucus that is green, yellow, or bloody
  • shortness of breath
  • rapid, shallow breathing
  • fever
  • sweating
  • chills
  • chest pain that worsens when you breathe deeply or cough
  • loss of appetite
  • loss of energy
  • fatigue
  • nausea and vomiting (especially in children)
  • confusion (especially in seniors)

Symptoms of additional lung-related complications

The symptoms of other CLL lung-related complications can vary depending on what complications you develop. For instance, you may cough up mucus from alveoli damage or another complication.

Other complications, such as pleural effusion, generally produce a dry cough. Almost all lung-related complications will include symptoms such as:

Treating lung complications in CLL involves treating both the complication and continuing to treat the CLL. For pneumonia and other infections, the first priority is helping your body fight the infection.

You might be given an antibiotic or antiviral medication. You might also receive additional anti-inflammatory medications, such as corticosteroids, to treat any inflammation.

For other lung-related complications, the treatment will depend on the complication. Some treatments might include:

You’ll also continue to receive treatment for your CLL.

There’s no cure for CLL, but many patients benefit from treatments such as chemotherapy and targeted therapy. The right treatment for you depends on how far your CLL has progressed and your overall health.

There’s no way to completely prevent leukemia and other lung-related complications when you have CLL. However, you can lower your chances of developing leukemia and other infection-based lung complications by reducing your risk of infections.

Here are steps you can take to reduce your risk of infections:

  • Get a flu shot.
  • Get a pneumonia shot.
  • Get any other vaccines recommended by your doctor.
  • Wash your hands frequently with soap and warm water before eating or touching your face and especially:
    • after using the bathroom, sneezing, or coughing
    • after touching animals
    • after touching trash or unsanitary surfaces
    • after returning home from crowded places
  • Carry hand sanitizer and alcohol wipes with you when you leave your house.
  • Use gloves if you need to touch dirt, debris, or other outdoor surfaces.
  • Wear shoes or slippers at all times.
  • Clean and bandage all scrapes and cuts right away.
  • Avoid large crowds if possible.
  • Wear a mask when you do need to be in a crowd.
  • Avoid friends or family who are ill.
  • Avoid hot tubs or communal water of any kind.
  • Avoid standing water, such as cups left out overnight.
  • Don’t share towels, clothing, cups, or utensils with friends and family.
  • Practice good daily personal hygiene (including dental hygiene).

Doctors may also recommend monthly IVIG (intravenous immunoglobulin) infusions for patients with:

  • recurrent infections (more than two per year)
  • low levels of circulating antibodies, due to either the disease or the treatment

IVIG infusions contain healthy antibodies collected from donors and can help prevent infections.

Chronic lymphocytic leukemia weakens your immune system and puts you at a higher risk of many infections, including lung infections like pneumonia.

CLL can also cause other damage to your respiratory system and can lead to lung-related complications such as damaged blood vessels in your lungs or fluid buildup around your lungs.

Treatment for lung-related complications will involve continuing to treat your CLL while addressing complications. You might take antibiotics, anti-inflammatories, or other additional medications to help you breathe better as you continue your CLL treatment.

Talk with a doctor about how to best treat and manage complications of CLL.

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