Leukemia is a type of blood cancer. In leukemia, cancer cells crowd out healthy white blood cells, red blood cells, and platelets in the bone marrow. If you have leukemia, having other health conditions at the same time can make leukemia harder to treat and may even influence your cancer prognosis (outlook). Understanding how other health conditions are related to leukemia can help you talk to your doctor about treatment and lifestyle changes. Addressing related conditions may improve your quality of life, help you live longer, and lower the risk of life-threatening complications.

What Is a Comorbidity?

When someone has more than one health condition at the same time, the conditions are known as comorbidities. Comorbid conditions may be related to leukemia in different ways. In people with leukemia, having a comorbidity can complicate cancer treatment and make managing the disease even harder.

Age plays a role in the risk of developing comorbidities. The longer a person lives, the more likely they are to be diagnosed with a chronic (long-term) condition. Older people are more likely to have multiple chronic conditions. Some types of leukemia are also more likely to develop in older adults.

Here are the average ages at diagnosis of the four main types of leukemia:

• Acute lymphoblastic leukemia (ALL) — 15 years
• Acute myeloid leukemia (AML) — 67 years
• Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) — 71 years
• Chronic myeloid leukemia (CML) — 64 years

Older people are more likely to have certain types of leukemia as well as other health conditions at the same time.

Why Do Comorbidities Matter?

When you are diagnosed with leukemia, cancer may seem like your biggest worry. In fact, having other health conditions might affect how your leukemia progresses. One large study on comorbidity in blood cancer included 2,550 people with AML, 1,000 people with CML, and 4,584 people with myeloma — a closely related form of blood cancer. Results of the study showed that people with cancer plus comorbidities were more likely to die from all causes, including blood cancer.

The related conditions that had the biggest impact on overall survival with leukemia included:

• Kidney disease
• Liver disease
• Heart and lung disease
• Brain diseases, including dementia, psychiatric conditions, and cerebrovascular disease (such as stroke)

Comorbidities can also lower your tolerance for leukemia treatment and limit your treatment options.

Common Comorbidities in Adult ALL

About 4 in 10 cases of ALL occur in adults. Treatment is more challenging in adults with ALL than in children because of comorbidities.

According to one study involving more than 1,200 people, the most common comorbid conditions in adults with ALL include:

• Infections
• Previous cancers
• Diabetes
• Heart disease
• Moderate lung disease
• Obesity
• Mild liver disease

Common Comorbidities in AML

Studies have shown that among older adults with AML, people with more comorbidities tend to have worse reactions to leukemia treatment and worse overall survival rates. People with AML may also be more likely to have certain chronic conditions. One study compared 3,911 people aged 65 or older with AML with the same number of similarly aged people without AML. Compared with those who did not have AML, those with AML were more likely to also have:

• Cardiovascular disease
• Type 2 diabetes
• Stroke

Common Comorbidities in CML

A study published in the journal Blood found that among 1,519 people with CML, those who had additional health conditions at the time of their leukemia diagnosis had shorter survival rates compared to those without comorbidities.

The most common comorbidities seen in people with CML include:

• Type 2 diabetes (diabetes mellitus)
• Other types of cancer
• Chronic pulmonary disease
• Renal disease
• Cardiovascular disease, including heart attack, heart failure, peripheral vascular disease, and cerebrovascular disease (including stroke)

Common Comorbidities in CLL/SLL

A large study from the journal Blood looked at 8,055 people with CLL over several years. Among the participants, 35 percent had one comorbidity, and 12 percent had multiple comorbidities. The most common comorbidities included:

• Chronic heart failure or history of heart attack
• Cerebrovascular disease, such as stroke
• Type 1 or type 2 diabetes
• Chronic lung disease
• Peripheral vascular disease (diseases of the veins and arteries)

Those with comorbidities were 14 percent more likely to die during the period of the study than those without comorbidities.

Conditions That Develop After Leukemia Treatment

Treatments for leukemia can cause long-term and delayed effects, beginning months or years after treatment for leukemia is complete. These long-term or late effects are known as sequelae. The term refers to conditions that follow after another disease or injury.

Some common sequelae after treatment for leukemia include:

• Cancer-related fatigue
• Bowel or bladder problems
• Sleep problems
• Anxiety or depression
• Cognitive problems, such as difficulties with memory or concentration
• Hearing loss
• Cataracts
• Thyroid issues
• Infertility in men or women
• Osteoporosis (thinning of the bones)
• Heart failure or damage to the heart muscle
• Other types of cancer

Your risk of developing complications from leukemia treatment depends on factors like the type of treatment and your age, overall health, and gender.

Talk to Your Doctor About Related Conditions

Your doctor can help you better understand your risk factors for developing related conditions and recommend steps to lower your risk. When you’re treating multiple conditions, be aware that some medications can cause dangerous interactions. Always make sure your health care provider is aware of every medication you’re taking for every condition, whether it’s available over the counter or by prescription, including any vitamins or herbal supplements.

Find Your Team

MyLeukemiaTeam is the social network for people with leukemia and their loved ones. More than 19,000 members come together to ask questions, give advice, and share their experiences with others who understand life with different forms of leukemia.

Do you know if you have any other health conditions that might impact your leukemia treatment? Have you talked to your doctor about how other health issues could affect your leukemia prognosis? Share your thoughts in the comments below, or start a conversation by posting on your Activities page.