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Patients Against Lymphoma

 

Treatment Support Guidelines or Patient to Patient

Minimize Risk of Infection

Last update: 07/08/2008

Also see Symptoms Checklist (PDF)

Low Blood Counts

It's not unusual to have delays in administration of treatments because of low counts, which are expected to drop from therapy.   During these times of suppressed immunity you are at higher risk of developing an infection.

You may want to inquire about the use of Neupogen (a blood cell growth factor) with your  doctors in order to 

  • help keep treatments on schedule and 
  • reduce the risk of infection between treatment rounds.

 NOTE:  "Neulasta should not be administered in the period between 14 days before and 24 hours after administration of cytotoxic chemotherapy because of the potential for an increase in sensitivity of rapidly dividing myeloid cells to cytotoxic chemotherapy."

Source: http://www.neulasta.com/professional/pi.jsp#precautions 

Nutrition will not help to restore blood counts significantly*, but you should pay attention to sources of infection from foods when his counts are low. 

See Diet for the immune suppressed and other topics in this section: http://www.lymphomation.org/chemo-support.htm 

* It may be important to include sufficient proteins in his diet, which are the building blocks or raw material for cells, but the rate at which replacement blood cells will be produced by the body is probably not affected much by nutrition, if at all.



TIPS for Minimizing Risk of Infection

The following tips are from the lay-membership of NHL-info,  an online support group. See disclaimer below.

  • Inquire about use of a blood cell support, such as Neupogen or Neulasta. 

    These are used to stimulate the production of granulocytes (a type of white blood cell) in patients undergoing therapy that will cause low white blood cell counts.  Each are used to prevent infection and neutropenic (low white blood cells) fevers caused by chemotherapy.  Source: chemocare.com

    NOTE:  "Neulasta (and probably Neupogen) should not be administered in the period between 14 days before and 24 hours after administration of cytotoxic chemotherapy (see DOSAGE AND ADMINISTRATION) because of the potential for an increase in sensitivity of rapidly dividing myeloid cells to cytotoxic chemotherapy."

    Source: http://www.neulasta.com/professional/pi.jsp#precautions 

  • Avoid places and people who will put you at risk, such as parties and crowded public events.
  • Food safety
    • Also see Diet for Immunosuppressed Patients below.
      Patients receiving chemotherapy and radiotherapy may have compromised immunity.
    • Avoid  moldy, spoiled and outdated food products.
    • Brush veggies with a vegetable brush and mild soap ALL over. Let them air-dry on a rack.  Thoroughly wash produce; cooking fruits and vegetables is best. Use vinegar to clean vegetables, and/or mild soap.

      Lettuce Learn How to Wash Produce  npr.org

      As many as 20 people may have touched your produce before you did, so make sure you wash all fruits and vegetables -- even those with peels and rinds.
    • Cooked foods are safer. Beware of foods that have been double-dipped. Inspect and clean fruits and vegetables. Use vinegar to clean vegetables, and/or mild soap.
    • Pay attention to purchase date & food labels - Do not purchase products older than the pull date.  Read labels.
    • Store and handle foods properly to avoid food-related infections and illness. 
  • Cleaning to reduce risk
    • Clean often. One thing that I do that surprises a lot of people is "Lysoling" the phone and the steering wheel of your car. Lots of germs there. Plenty of rest, juice, washing hands at appropriate times, etc. I also carry antibiotic hand wash but I don't use it too often - it's not supposed to be that good for you but in emergencies when I have been out (subway, etc) and can't wash hand, I'll use it. - Ronnie (CT)
    • Change your pillows - a hot bed of fungal spores (October 14, 2005)  sciencedaily
      "Researchers at The University of Manchester funded by the Fungal Research Trust have discovered millions of fungal spores right under our noses - in our pillows.   
      Aspergillus fumigatus, the species most commonly found in the pillows, is most likely to cause disease; and the resulting condition Aspergillosis has become the leading infectious cause of death in leukaemia and bone marrow transplant patients. Fungi also exacerbate asthma in adults."
    • Let others do the dishes etc ... Let the dishes air-dry. Whoever stacks them should wash their hands before doing so. 
    • Use disposable paper towels instead of hand towels. 
    • Use bath towels ONCE. Don't use anyone else's towel. Towels are great breeding grounds and/or retainers of all kinds of stuff, especially skin surface critters.
  • Wash your hands often. Keep your unwashed hands away from ALL mucous membranes, especially the nose, eyes, and mouth. You are more likely to catch a cold through your nose than your mouth because saliva contains a lot of bacteria-killing enzymes.

    * * It is best to wash your hands with soap and clean running water  cdc
  • Avoid touching your mouth, nose or eyes with your hands.
  • Beware of foods that have been "double-dipped."  
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Lay- Recommendations

IMPORTANT: Please consult with your treating doctor about the use of any supplement with treatment.
  • Acupuncture can be effective in treating pain, fatigue, and nausea caused by cancer therapies.
    Acupuncture for management of pain.

    Vet Clin North Am Small Anim Pract. 2000 Jul;30(4):875-84, viii. Review.
  • Cranberry is sometimes useful for fighting bladder infection. You can obtain pure cranberry, without sugar, from your local health food store.
  • Garlic: Dr Weil has this to say about garlic: "Garlic, for instance, is a natural antibiotic that can help your body combat bacterial infections - and it even works against fungal infections and viruses when you eat it raw. I recommend one to two cloves of garlic a day for people with chronic infections. "
  • Moderate exercise. Studies show that moderate (not strenuous) exercise improves immune function. Be sure to discuss limitations with your doctor.
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Supplements & Conditions 

Also see Chemoprotective Strategies | Radioprotective Strategies

IMPORTANT: Please consult with your treating doctor about the use of any supplement with treatment.
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Disclaimer:  The information on Lymphomation.org is not intended to be a substitute for 
professional medical advice or to replace your relationship with a physician.
For all medical concerns,  you should always consult your doctor. 
Patients Against Lymphoma, Copyright 2004,  All Rights Reserved.