DEAR DR. GOTT:
I am writing on behalf of my husband. He is 80 years old and has been suffering with chronic lymphocytic leukemia. Up until the last couple of years it has progressed very slowly and he was advised to do nothing. Now, however, it has advanced to where his white blood count has risen dramatically, his platelet count is very high and his red blood count is low. He also has a problem that no one has been able to solve; his skin has become dry to the point of continually flaking off when rubbed. It is also very itchy but if he scratches it either bleeds or raises welts. This happens day and night. He has seen a dermatologist who said it might be an allergy to his blood pressure medicine so it was switched. There was no change so the dermatologist gave him a prescription for a cream. He has tried every lotion and cream on the pharmacy shelves but nothing touched the itch. He even tried castor oil to no avail.
Have you ever heard of such intense itching associated with leukemia? Is there any relief to be had? He is about to lose his mind.
He is also constantly cold because of his low red blood count but doesn’t wear wool, preferring layers, sport silk underwear and fleece jackets. At night he uses an electric blanket.
DEAR READER:
Your husband has is a type of cancer that affects the blood and bone marrow. Chronic lymphocytic leukemia (CLL) is a slow, progressive form of leukemia that affects a specific type of white blood cells known as lymphocytes.
Chronic lymphocytic leukemia is caused by damage to the DNA of newly forming cells in the bone marrow. Leukemia can develop for two reasons; one is due to damage that turns on oncogenes which control cell division and the other is due to damage that turns off tumor suppressor genes that tell cells when to die. In either way, the affected cells cease to function properly. In your husband’s case, the lymphocytes then gather in the blood and other organs and interfere with the normal blood cell production.
The reason this happens is unknown but doctors and researchers have found that many people with CLL have chromosome deletions (loss of part of one of the 23 pairs of chromosomes that make up DNA). Some individuals have an extra chromosome or other type of chromosomal abnormality. Most cases of CLL aren’t inherited but a small percentage of sufferers have a family history of the disorder or of lymphoma.
Often, there are no early signs or symptoms but in some cases fever, weight loss, night sweats, fatigue, lethargy and/or loss of appetite can be present. The disorder is often an incidental finding during normal blood testing. Symptoms of advanced CLL stages can include anemia (which can lead to paleness, fatigue, shortness of breathe and more), low white blood cell count (may cause frequent infections) and low platelet numbers (leads to bruising, abnormal blood clotting, etc.). Chronic lymphocytic leukemia may also cause bone or joint pain, liver and spleen swelling and enlargement of lymph glands in the stomach, groin, neck or underarm.
There are procedures and new medications available for treatment of aggressive or advanced CLL; however, there is no known cure.
I urge your husband to return to his oncologist for further testing and to discuss the possibility of treatment. While no one seems to know the cause of your husband’s skin issue, perhaps it will subside if the CLL is treated.
I would also like to add that persistent itching may also be a sign of kidney damage. Perhaps your husband’s condition has now progressed to a point where it may be causing organ damage. Another possibility is if your husband has recently undergone radiation treatment.
I believe your best chance of finding a solution will to be to start with the oncologist. Your husband needs answers, especially since his chronic lymphocytic leukemia appears to be worsening. If he or she cannot help, it may be time to turn to the super-specialists of a teaching hospital or clinic such as the Mayo Clinic or others. Let me know what happens.
To give you related information, I am sending you a copy of my Health Report “Blood — Donations and Disorders”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.
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