tag:blogger.com,1999:blog-19102494.post1267453260907306796..comments2023-10-07T07:52:24.587-07:00Comments on CLL Diary: Debulking: the amazing photographic evidenceDavid Arensonhttp://www.blogger.com/profile/13876562687586184006noreply@blogger.comBlogger9125tag:blogger.com,1999:blog-19102494.post-20501978977983340792007-04-08T12:13:00.000-07:002007-04-08T12:13:00.000-07:00There is indeed a clinical trial using low-dose Ri...There is indeed a clinical trial using low-dose Rituxan (20 mg) in patients, and there had been a pilot study before that. Here is a link to the trial:<BR/><BR/>http://clinicaltrials.gov/show/NCT00366418<BR/><BR/>I think the shaving effect has pretty much been demonstrated; the question is, how well will low-dose Rituxan work in patients. That is the bottom line. <BR/><BR/>The pilot study had encouraging results. Here are links to two abstracts:<BR/><BR/>http://abstracts.hematologylibrary.org/cgi/content/abstract/104/11/2520?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=1&author1=Taylor%252C+RP&andorexacttitle=and&andorexacttitleabs=and&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT<BR/><BR/>http://abstracts.hematologylibrary.org/cgi/content/abstract/106/11/2970?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=1&author1=Taylor%252C+RP&andorexacttitle=and&andorexacttitleabs=and&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCITDavid Arensonhttps://www.blogger.com/profile/13876562687586184006noreply@blogger.comtag:blogger.com,1999:blog-19102494.post-7071372576840294712007-04-06T09:21:00.000-07:002007-04-06T09:21:00.000-07:00FYI, I believe there is a clinical trial on the 's...FYI, I believe there is a clinical trial on the 'shaving' phenomenon with Rituxan. That should settle the dispute once and for all. There are arguments on both sides.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-19102494.post-3409472801383881032007-04-05T21:25:00.000-07:002007-04-05T21:25:00.000-07:00I am still on low-dose Rituxan, 20 mg/m2, every Mo...I am still on low-dose Rituxan, 20 mg/m2, every Monday, Wednesday, and Friday. WBC yesterday was 84,000, droppping 11,000 from two days before. Assuming this rate of reduction continues -- a BIG assumption -- it will take another seven or eight infusions to get me to normal WBC, if that is in the cards. The original plan was to do it for 12 weeks, and I began March 12.<BR/><BR/>I definitely think there may be a role for lower-dose steroids in some patients, combined with low-dose Rituxan. 72 mg of methylprednisolone is not really low-dose, by the way. It just seems so in comparison to the 1 gm/m2 used at UCSD. I am now stepped down to 12 mg daily, which is fine with me -- enough to keep the nodes at bay while the Rituxan does its thing.<BR/><BR/>Yes, I do remember Joe Tullman and his reports of increasing his shirt collar size as the nodes grew. Fortunately, I don't have to wear a tie to work (I work at home). Heck, I don't even have to wear pants.<BR/><BR/>I think one especially valuable thing about low-dose Rituxan is this: with CLL cells flushed out of nodes, spleen and marrow into the peripheral blood for the first time, they are virgin targets for Rituxan. It makes sense that we avoid CD 20 shaving here, as we want to get the maximum kill and avoid shaved cells getting back into the nodes and becoming that much more resistant to Rituxan treatment. Yes, I know CD 20 is supposed to "grow back," as it were, but I don't think that issue has been studied enough to know the extent to which it returns. So why take chances with shaving.David Arensonhttps://www.blogger.com/profile/13876562687586184006noreply@blogger.comtag:blogger.com,1999:blog-19102494.post-34671244201409621562007-04-05T11:03:00.000-07:002007-04-05T11:03:00.000-07:00Interesting that you seem to be taking a low-dose ...Interesting that you seem to be taking a low-dose steroid. There is news today that low-dose steroids in multiple myeloma combinded with lenalidomide (the thalidomide derivitive) leads to prolonged survival compared with high-dose steroids.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-19102494.post-23861333972361145562007-04-04T11:50:00.000-07:002007-04-04T11:50:00.000-07:00Are you still taking the low dose rituxan? If not...Are you still taking the low dose rituxan? If not how long were you taking it?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-19102494.post-61942587419560093582007-04-02T15:34:00.000-07:002007-04-02T15:34:00.000-07:00Several people on the acor list have mentioned lar...Several people on the acor list have mentioned large nodes, including Joe Tullman (do you remember him?). The 11q del is not as serious as 17p del, but the bulky nodes are definitely a concern. <BR/><BR/>Luckily, there are steroids and a number of other drugs that work on bulky nodes.<BR/><BR/>Please keep us informed as to your thinking regarding further treatment.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-19102494.post-3878826752782064742007-04-02T05:54:00.000-07:002007-04-02T05:54:00.000-07:00David-Since Tom is on camera, he really couldn't w...David-<BR/>Since Tom is on camera, he really couldn't watch and wait when his nodes were so big. We both didn't realize how large they had become though. Same thing with you. Tom looked so skinny after FCR....we were happy campers. Dr. Keating once said that emotionally it is bad to look in the mirror everyday and "see CLL". I agree with him. Once the nodes are reduced, a sort of positivity sets in to help fight this cancer. You look super fine Dude.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-19102494.post-56055715149472609372007-04-01T17:47:00.000-07:002007-04-01T17:47:00.000-07:00David,That is AMAZING! The photos I mean!Keep get...David,<BR/>That is AMAZING! The photos I mean!<BR/>Keep gettin' on!<BR/>CarlinAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-19102494.post-50560904427316840592007-03-31T23:18:00.000-07:002007-03-31T23:18:00.000-07:00The thought of all those CLL cells fleeing your no...The thought of all those CLL cells fleeing your nodes to end up flushed to a place they really belong (I will remain polite) is making me do a huge happy dance. :)Steve Maddenhttps://www.blogger.com/profile/10284036509040132904noreply@blogger.com