Want to connect with others with Splenic B cell Marginal Zone Lymphoma

Hi. The second treatment was less eventful and the rest were all easy. Just a bit tired that day and following day. good luck

Hi all. I was diagnosed with SMZL last July (2023). I have had a course of
rituximab. In preparing for this it was also discovered I had Hep B. So I am also taking an anti-viral for that daily. So I went from thinking I was basically healthy for a 63 year old, to being diagnosed with 2 serious underlying conditions in the space of a few weeks. Disconcerting. I have made my peace with both of them, sort of, and I am just confused about how immunocompromized I am, and what precautions are necessary right now.

Hi Sue,

It sounds like you have a 6 months head start on me (I have yet to get my final diagnosis, so no treatments planned quite yet). We're the same age as well. I'm puzzled why your docs have not addressed these questions – I am really curious as well. I am sure others on this channel with more SMZL experience can help.

Paul

Hi Paul. Good question. What the docs say are "take reasonable precautions" but I am not really sure what that means. They have also said that I should wear a good mask when I am in prolonged close contact with people and they have used being on an airplane as an example. But this still leaves me not feeling clear enough. I was wondering if the group here might have any experience or thoughts.
Good luck with your final diagnosis, and thanks for responding to my post!
-Sue

Hi @sueinma. Welcome to Connect. Anytime we have a condition where our immune system isn’t functioning at 100% we are susceptible to illness. Having a blood cancer such as lymphoma affects your immune system directly. You may have a more difficult time with recovery from an illness or may find you get ill more frequently. It’s important to make sure you stay up to date with all immunizations.

Being immunocompormised, you’ll want to take similar precautions that you learned with Covid protocol with using N-95 or KN-95 masks in public or if you have guests in your home who are ill. You’ll definitely want to wear them on planes, in airports, church, theaters, elevators, etc., where there are groups of people in an enclosed, not well-ventilated area. Covid is obviously still a concern. But also other diseases/illnesses such as flu, RSV, measles and the like. Also things to avoid are areas of possible contamination for foods such as buffets, salad bars, artisan cheeses that aren’t pasteurized. You don’t have to live in fear. Just be educated and don’t take chances.
I’m 5 years post AML/bone barrow transplant. Even though I’m perfectly healthy with no cancer, I still need to wear masks, use hand sanitizer and we don’t go out to dinner unless we can eat outdoors.
Here’s a quick tutorial from Healthline.com
https://www.healthline.com/health/staying-healthy-while-immunocompromised

Do you wear a mask in public places?

Thank you Lori for your thorough response. Yes, even before my diagnosis I went back to wearing masks in crowded public indoor places like supermarkets. Now I am wondering how much I should be masking in general when indoors, like when I am visiting with grandnieces who appear to be healthy, or at my new job when I will be in an office, sometimes with one other person for periods of time. I would hate to have to always be separated by others by masks for the rest of my life.
I also wonder about how this changes over the length of time it has been after a dose of rituximab since that med definitely increases or degree of compromise.

This is a tough one to answer, Sue…when to wear a mask. For me, wearing a mask is second nature now. I wear a mask when I’m out shopping in any store, or elevator or in a car with someone other than my husband. I wear a mask in a friend’s home or even when people visit in my home. They are asked to wear one too. Even when my daughter and son-in-law come for a week or so, while we’re in the house, they pop on a mask. It’s not a big deal. We actually eat with masks on by pulling it down, taking a bite, replacing it. That way we can talk, laugh freely and enjoy our mealtime without worrying about aerosol. Since I know my husband is cautious, we don’t wear masks when we’re alone together inside.

I realize this can seem like overkill, but since we have no idea how my body will react to illnesses, especially Covid, a mask is my first line of defense. And it has served me well for the past 5 years.

Children are germ bombs so I’d especially be mindful of wearing one around your grandnieces. In the workplace, having an appearance of being healthy can be deceiving too. While you may think your coworker is perfectly healthy, you won’t know until they don’t show for work one morning because they’re home with the flu. That means you were exposed the day before.

Receiving a Rituximab infusion can lower your resistance for several months. This medication affects the B-cells (white blood cell that makes infection-fighting proteins called antibodies), which are an important part of your immune system, your body’s defense against harmful pathogens (viruses, bacteria and parasites) that enter your body and make you sick. So for that time span it would be important to be cautious to avoid exposure to infection or illnesses.

Ask yourself this…since you’ve been diagnosed, have you found yourself becoming ill more frequently such as catching a cold? Just use your good judgment in situations. If you get the spidey sense that this may be a situation where it’s best to use a mask, then put it on. If you’re in a grocery store and it’s not crowded, with lots of room and ventilation, then you may not need one. I think over time you’ll get the feel for when it’s appropriate and when it’s not necessary.

Thank you.

Hi @loribmt –

Since you had a bone marrow transplant 5 years ago, wouldn't that have given you back a healthy immune system? Or, are you still (a little, a lot?) more susceptible to catching something than you were before you had cancer?

Thank you,
Paul

Hi Paul, That’s a discussion I’ve had many times with my transplant doctor. My donor was a 20 year old male from the U.S. From my perspective, 5 years later at 70 years of age, I quite frankly feel like I’m in my 20s! I’m healthy and incredibly fit. I joke about having super human powers because if I get a cut or burn on my hand, it heals within a very short span of time. So I can’t help but think that I have a really strong, new immune system.
Before AML and transplant, I was rarely ever ill in my life and that remains true today. In the 5 years since my transplant I’ve been very judicious wearing my mask, avoiding high exposure events and since that time I’ve had no infections at all. I’m quite happy not tempting fate. ☺️

However, from what I’ve learned, my new system, no matter how strong it is, will never be as robust as ‘the factory installed model’.
There’s no way to fully measure the strength of my immune system. I’ve had all of my childhood, adolescent and adult vaccinations. However, it’s been noted in numerous studies, after vaccinations in stem cell transplant patients, that generation of antibodies is markedly lower. There’s no information that I’ve seen as to what the B and T Cell responses are. So this remains an unknown.

Another reason I don’t risk developing a serious illness is because of a side effect of transplant referred to as GVHD. Graft vs host disease. My new immune system (the graft), is the controller of all things! It looks at my body (host) as the invader. So if there is a source of inflammation the immune response is to rush to the rescue. This can cause the system to go into high alert and the results or level of response can be unpredictable. Small things can become potentially life threatening. So it’s better to be safe than sorry. ☺️