tag:blogger.com,1999:blog-19102494.post115844144357053135..comments2023-10-07T07:52:24.587-07:00Comments on CLL Diary: The Abominable Lymph NodeDavid Arensonhttp://www.blogger.com/profile/13876562687586184006noreply@blogger.comBlogger3125tag:blogger.com,1999:blog-19102494.post-1158631716167814842006-09-18T19:08:00.000-07:002006-09-18T19:08:00.000-07:00Rituxan will be part of the treatment but I think ...Rituxan will be part of the treatment but I think I am past the point where it can be the only part of the treatment. I know Dr. Byrd thinks Rituxan 3 x week for 4 weeks may do better than the Rituxan schedules I have had in the past -- he is probably right -- but even then the prospect of 50% or greater node clearance lasting 10 months is only 40%. There may be an opportunity cost to my using that much Rituxan without adding something that is known to get those nodes down.<BR/><BR/>Candidates for addition to Rituxan are:<BR/><BR/>*a low-dose steroid such as dexamethasone, administered to reduce nodes prior to commencing Rituxan<BR/>*a high-dose steroid such as HDMP, a la UCSD<BR/>*chlorambucil<BR/>*GM-CSF<BR/>*Beta Glucan<BR/>Perhaps more than one of the above.<BR/><BR/>I am trying to nail down the logic and risks/rewards of some of these moves. I'll discuss that here when I get it settled.<BR/><BR/>I would be shocked if HuMax-CD20 doesn't make it to market. It has survived Phase 1/11, shows no unacceptable toxicity, and has FDA fast-track status. Plus from what I have heard, it really does seem to work better. It was developed in the lab of Dr. Martin Glennie, no slouch in the monoclonal biz. I would define it as a very realistic hope. <BR/><BR/>I have tried honokiol with no evident beneficial result. The same is true of EGCG. My case of CLL is more bulky and advanced than many; the really soft-glove stuff is unlikely to work. I do, of course, keep my eye out for such things. Beta Glucan as a Rituxan booster is one interesting idea.David Arensonhttps://www.blogger.com/profile/13876562687586184006noreply@blogger.comtag:blogger.com,1999:blog-19102494.post-1158628835292669152006-09-18T18:20:00.000-07:002006-09-18T18:20:00.000-07:00Very well written as always. I do not know if the...Very well written as always. I do not know if the groin nodes are the largest in the body but they have always been an issue for me as well although not to the extent you describe. Good luck. <BR/><BR/>LorenAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-19102494.post-1158626514590210922006-09-18T17:41:00.000-07:002006-09-18T17:41:00.000-07:00As I recall, you had treatment with rituximab as a...As I recall, you had treatment with rituximab as a single agent. Is that what you are considering for this bothersome node? I've read of your journeys...<BR/><BR/>The supposition, of course, is that HuMax will be approved. Nothing is written in stone, AYK. As the Paul Simon song goes (slip sliding away), 'God makes His plans; the information is not available to the mortal man.'<BR/><BR/>Have you thought about Chinese traditional medicine, honokiol, or something of that nature? I have a CLL friend who's been using honokiol, and she's been happy with the results.<BR/><BR/>As always, YMMV.Anonymousnoreply@blogger.com