Dear Dr. Roach: I had a splenectomy in 2012 because an oncologist thought I had NK lymphoma. After pathology, I was informed that I had an unusual immune system with a lot of NK cells, but no cancer. I was very happy, but I鈥檓 wondering how to take care of myself now that I don鈥檛 have a spleen. I鈥檓 going to be 70 years old next month.
R.L.
NK (natural killer) cells are a subtype of lymphocytes, a white blood cell. Leukemias and lymphomas of NK cells are unusual. The cells are important for immunity -- especially for viruses and possibly for cancers. Unlike T cells and B cells, they 鈥渒now鈥� how to recognize tumour cells and virally infected cells without having seen them before. Having too few NK cells predisposes a person to viral infections, so let us hope that your having many of them is protecting you.
The spleen has important functions in immunity and in removing worn-out red blood cells. The liver takes over some of the spleen鈥檚 job after the spleen鈥檚 removal, but people without a functioning spleen are at risk for certain infections. Some of these can be immunized against, especially pneumococcus, a major cause of blood infections, pneumonia and meningitis. You already should have had two vaccines for pneumococcus: the PPSV23 and the PCV13. If you haven鈥檛 or aren鈥檛 sure, you should talk to your doctor about getting them.
A meningococcal vaccine also is recommended to prevent a common type of meningitis. It鈥檚 especially important for you to get your yearly flu vaccine.
Finally, it鈥檚 a good idea to get a medical alert bracelet (for 鈥渟plenectomy鈥�).
