Friday, May 1, 2009

Cholesterol and CLL-How's it Going?

My one reader will remember that I've decided to postpone killing CLL cells by dying. One thing to do this is to deny the cells the means with which to grow. Cholesterol levels are dysregulated by CLL, possibly because the rapid growth of the clone (that is, the CLL cells) require cholesterol to form the cells themselves. That is one theory, at least.

Believing that reducing cholesterol in my diet and reducing it further by adding a bit of fiber to my diet probably won't hurt me, I embarked about a month ago on a fiber-added diet. I must report that the results of my little experiment is inconclusive at best.

One of the 'problems' is that, at the present time, my WBC is quite low, below even the normal range due to my recent bad experience with FCR (fludarabine, cyclophosphamide, and rituximab) for my CLL. So I can't report a huge drop in the WBC numbers. I can look at the ratio of neutrophils to lymphocytes (the two largest components of the white blood count). It has bounced around, but still shows too many lymphocytes. The ratio has not changed for the better.

So, I am not bouyed by these results. I will continue to add a teaspoon a day to my diet, because I probably don't get enough fiber as it is, and adding a bit won't hurt. Didn't seem to help, don't think will hurt.

I'm thinking on embarking on a different CLL journey in the near future; alternating EGCG with curcumin. A recent paper shows that the combination seems to work better than either does alone.

More later.


John Wagner said...

Your one reader? I imagine you have many, but we don't often comment. I see the word counter at the bottom, do you have something that actually counts visitors?

This is an interesting post. I don't remember reading anything like this before. For years prior to diagnosis, my cholesterol levels were quite high, even with medication. A year or two before diagnosis they started dropping and have been in the normal range for a several years now. If I understand you correctly, the CLL cells are gobbling up the cholesterol? And here I was feeling proud of myself for at least getting that number under control. Sigh.

Barry B. said...

Yeah, I added a counter to see if anyone other than myself was reading this thing. It doesn't work...

Anyway, I did read a paper some time ago that asserted that cholesterol counts were skewed in CLL, and counts couldn't be counted on to assess the actual health of the individual.

I also had a gentleman in my Sacramento CLL group who told me that his HDL count was zero.

I suppose I make the guess that this is what was happening since my HDL count also dropped into the teens. Several physicians were concerned about that, and I was puzzled too since I am an ova-lacto vegetarian, and my cholesterol counts have always been pretty good.

Here is one paper that addresses the subject: It says, "statistically significant values included reduced cholesterol ..." in all blood cancer patients studied.

Here's another: This abstract concludes, "Similar alterations have been noted so far as apo B is concerned. It has been demonstrated that the decrease in HDL-CH (p less than 0.05) is also dependent on the disease stage. The simultaneously increasing index HDL-PL/HDL-CH indicate on changes within the HDL2 and HDL3 subfractions suggesting a deficiency of the HDL2 subfraction. The total lipemia and the lipoprotein fraction alterations observed make the diagnostic value of the atherosclerotic threat in patients with CLL doubtful with the use of that parameters."

I take the leap further to conclude that the decline in HDL numbers mean that cholesterol is being used up in progressive CLL.

That assertion is a bit buttressed by this: "The CLL cells have an increased demand for cholesterol (membrane synthesis)."

And this: "Therefore, pharmacological reduction in cholesterol levels in leukemia cells could help prevent proliferation of malignant B-lymphocytes."

(These last two are from a book called, "Natural Terpenoids as Messengers" P. Harrewijn, going at Amazon for a mere $213.00.)

As I mentioned in the original blog post, there are some contradictory papers on the subject, but I felt that upping the fiber on my diet might be able to make some difference in the progression of the disease. However, in a short trial of a few weeks, I noticed no difference in my counts, and my enlarged abdominal nodes (my main complaint) are unchanged. In fact, one must be very careful with enlarged nodes in this area not to cause or exacerbate abdominal obstruction.

Anyway, for those without massive abdominal nodes, I don't think it can hurt, and it might buy some time. It certainly isn't a cure.

Beverley said...

I've had excellent cholesterol levels for years, but since being diagnosed with CLL they've jumped to way over what the doctors are happy with... I'm reducing my saturated fats (not that I eat a lot of them!) and upping my fibre and am exercising more.

I'm very interested in this potential link between CLL cells and cholesterol.

Thanks for the post.

Grateful said...

One interesting area of research is about finding what antigens your CLL cells react to and correlating this with what IGVH gene your CLL cells use. It is thought that one way CLL arises is from chronic antigen stimulation by a relatively limited set of antigens. Some CLL cells react to many different forms of cholesterol, so cholesterol may be a CLL trigger for some patients. For example, IGVH3-21 CLL reacts to many different forms of cholesterol. CLL cells in another patient with a different IGVH gene do not react to cholesterol, so cholesterol would not be a CLL trigger for those patients.

Barry B. said...

Thanks for the information.

It is indeed one of the holy grails to find that agent which stimulates the growth of CLL cells. Identify it, the thinking goes, switch it off, and suddenly your CLL, though not eliminated and not cured, might as well be.

Unless it finds something else to stimulate it.

My cholesterol has been very low (total) since I started eating a mostly plant-based diet in my mid-twenties. I've generally been fairly active, and kept the weight off, the pulse low, and the energy level high.

All that went away with the development of the beast, sad to say.

I still am a vegetarian (though eating occasional cheese and eggs). Since my CLL has taken off with little or no abatement, I don't think cholesterol is my trigger.

I wonder what mine is. I'd love to know.

I wonder if there would be some way to find out. I suppose that would take a lot of time and money to grow an individual patient's CLL cells, categorize the protein that would fit into the B cell receptor, and activate it. If that is the way CLL progresses.

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