Peripheral neuropathy is a rare complication of chronic lymphocytic leukemia. It may also be a side effect of certain cancer treatments, such as chemotherapy.
Chronic lymphocytic leukemia (CLL) makes up about
The most common complications of CLL include:
- infections (prolonged or frequent)
- anemia
- thrombocytopenia
Peripheral neuropathy (PN) is a very rare manifestation of CLL.
What is peripheral neuropathy?
PN is caused by damage to your peripheral nerves, which carry messages both to and from your brain and spinal cord. Symptoms depend on the exact type of peripheral nerves involved, but may include:
- sensations of numbness, tingling, or “pins and needles”
- discomfort or pain
- muscle weakness
- muscle cramps
- severe pain from only the lightest of touches, called allodynia
- heat intolerance or cold intolerance
- difficulty regulating blood pressure, which can lead to dizziness or fainting, especially when standing up
- urinary incontinence
- digestive symptoms like constipation or bowel incontinence
- trouble with walking, balance, or coordination
PN is uncommon in people with CLL, but may develop from leukemia treatment or caused by co-occurring conditions, including:
- shingles
- myeloma
- diabetes
- fractures of the spine bones that may pinch nerves
- autoimmune conditions like rheumatoid arthritis and lupus
- thyroid disease
- kidney disease
- chemotherapy drugs
- radiation therapy
Cancer treatment and PN
PN is rarely associated with leukemia itself. Instead, it usually develops from one or a combination of other causes, such as treatments for cancer, especially chemotherapy.
CLL treatments may lead to PN, including:
- BTK inhibitors
- Rituxan (rituximab)
- Fludarabine
- Cyclophosphamide
- Treanda (bendamustine)
CLL can lead to a variety of complications, including:
- low blood cell counts, which can lead to:
- autoimmune cytopenia, which is when your body makes antibodies that target healthy blood cells
- Richter transformation, an aggressive form of lymphoma, or prolymphocytic leukemia
- transformation into acute types of leukemia, like acute lymphocytic leukemia (ALL) or acute myeloid leukemia (AML)
- other cancers, including but not limited to:
- skin cancers, particularly melanoma
- lung cancer
- gastrointestinal cancers
- Kaposi sarcoma
- head and neck cancers
- other types of blood cancer, such as AML or lymphoma
The treatment of PN depends on which types of peripheral nerves are affected. Some of the potential treatments that a doctor might recommend include:
- medications, such as certain antidepressants or seizure medications, to help ease discomfort or pain due to PN
- topical numbing creams or patches that can be applied directly to an affected area
- transcutaneous electrical nerve stimulation (TENS), which can help relieve pain by delivering an electrical current to the affected area via small electrodes
- physical or occupational therapy to work on your motor skills, strength, and balance
- assistive devices, such as canes or grab bars, to aid you in moving around safely
- psychotherapy to help you to cope better with your symptoms
- complementary therapies, such as acupuncture or massage, to help ease symptoms
PN isn’t a common occurrence for people with CLL, but may develop from cancer treatment and co-occurring conditions like shingles, diabetes, and lupus.
If you’ve recently received a CLL diagnosis, it may be a good idea to let them know if you’ve ever had symptoms of neuropathy, like tingling or numbing in the limbs or loss of sensation. This will help your health team tailor CLL treatment or take certain precautions.