Q ▶ What is “secondary immunodeficiency disease” (SID)?
Note: The “canswers” moniker in socialcurrentsee for these posts is a reference to the Q&A methodology embraced by the author, a self-described canswerist, or cancer survivor and blogger. Actually, for a definition of “canswerst,” see: URBAN DICTIONARY
As a cancer patient since 2006 who enjoys continuous remission of mantle cell lymphoma (MCL) since 2010, I have come face-to-face with SID on numerous occasions, including the present time. A Google search, good medical dictionary and the VIDEO (in the slideshow below) tell the story in a semi-clinical way, but allow me to approach the subject with a personal account.
Even though I am not cured of cancer (per se), the spring of 2019 marks 14 years since diagnosis (DX) with the blastoid type of mantle cell lymphoma. It was 2006 and less than two months before my 58th birthday.
What followed was an initial chemotherapy regimen titled R-CHOP (the “R” stands for Rituximab (a type of medication called a monoclonal antibody. It works by attaching to certain blood cells from your immune system (B cells) and killing them.)
While I was not fortunate to obtain lasting and long-term remission with chemotherapy, that treatment helped to survive long enough to receive an allogeneic stem cell transplant (alloSCT) in August 2007, some 16 months after my original MCL DX. As it turns out, the Rituximab therapy would occur numerous times before and after the alloSCT. As it turns out, that very miracle drug happens to be the root cause of my experience with SID, or the immunodeficiency that manifests with an inability to quickly recover from upper respiratory issues (prolong coughing and sinusitis).
Hopefully, not getting too clinical, perhaps even morbid, with further explanation, I have discovered a universal reality, Rituximab (Rituxan) is a first-line effective treatment for most blood-related cancer patients, but it comes with life-long consequences for the immune system, or a medical condition known as hypogammaglobulinemia.
Thus, the common periods of respiratory distress that I can’t seem to shake persist because of my low IG levels (see chart below).
The most significant gamma globulins are immunoglobulins (antibodies), although some immunoglobulins are not gamma globulins, and some gamma globulins are not immunoglobulins. But the gamma globulins of note here are those that are vital for normal immune system function, the blood molecules that help ward off and fight infection.
The most recent charting of these IG levels for me show that throughout 2018, all six of my IG (blood) tests produced results well below the 700-minimum range. The last test on Nov. 20 returned a result of 418 when the protocol for an outpatient prescription of an IVIG (infusion of what is called gammagard) requires a sub-400 reading.
Therefore, we await that IVIG, now scheduled for Dec. 18. We hope we can reschedule this infusion for an earlier date.