Re: 11q and no swollen nodes

[Guest guest]

Helene

The data on FCR shows that it works well in all 11q del. I do not

believe node size was teased out as a variable when looking at that

data, but I would suggest you read the whole CLL8 trial to see if it

buried somewhere

Having small nodes can only be good, because big nodes are hard to

treat and nodes are where the cancer grows much more so than the

marrow or blood

One caveat: With 11q del it is very possible to have small or no

palpable nodes and big mesenteric (gut) nodes, only seen on CAT scan.

That has been my situation twice.

Be well

On Apr 5, 2011, at 9:45 PM, elmerleb wrote:

Does anyone have, or know about, having an 11q deletion with no

swollen nodes?

Does this just mean very early disease, or do some 11qs not have this

manifestation?

I am wondering if a) no swelling means a less aggressive version of

11q - is there such a thing? and if FCR is the treatment of choice

for 11q, mainly because it is so effective on lymph nodes, does it

remain the treatment of choice if the person does not have swollen

nodes?

Thanks,

Heléne

[Guest guest]

Hi Helene,

My impression (from remarks made by experts such as Furman and what I've copied

below) is that the utility of cytogenetic markers like 11q is not clear... and

that classic staging remains the most reliable way to guide decisions in regular

clinical practice -- outside of a trial.

" As the mysteries of the biology of CLL are revealed, important biological

prognostic parameters are claiming a place in the prognostic assessment of the

disease. The staging systems developed in the early 1970s have been crucial in

the progress of our understanding on CLL.

Because of their simplicity and reproducibility they have been widely employed.

They have also been critical in conducting randomized treatment studies in

comparable series of patients, and in attracting the interest of a new

generation of younger physicians and investigators to an old disease. To abandon

the clinical staging systems would be not only precipitous, but unwise.

Rather than replace clinical stages and other simple prognostic parameters (e.g.

degree of bone marrow infiltration, white blood cell count, doubling time),

these new factors should currently be employed to refine the prognostic power of

classical prognostic factors.

Finally, clinical staging systems and other prognostic factors were developed in

an era in which no effective therapy existed for CLL. Since prognostic

indicators may change as more effective therapies become available, prognosis

should be assessed prospectively in patients treated with the newer and more

effective therapies. Only in that manner will the most relevant prognostic

factors for CLL eventually be identified, a quarter of a century after the

introduction of clinical stages. "

http://annonc.oxfordjournals.org/content/15/10/1450.full

Hope this helps.

Karl

>

> Does anyone have, or know about, having an 11q deletion with no swollen nodes?

> Does this just mean very early disease, or do some 11qs not have this

manifestation?

> I am wondering if a) no swelling means a less aggressive version of 11q - is

there such a thing? and if FCR is the treatment of choice for 11q, mainly

because it is so effective on lymph nodes, does it remain the treatment of

choice if the person does not have swollen nodes?

>

> Thanks,

>

> Heléne

>