Re: Denyse ready for treatment

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Greetings & best wishes, Denyse. No doubt you are reassured by Dr. Furman's comment that you have excellent treatment options to choose from. Your white count is not out-of-sight, and it is promising to know that you feel good. So, expect the best! wayne -------------------- Wayne McPherson67, CLLdx 9/99, stage 1, trisomy 12, CD38+, unmutated, ZAP70+w & w, WBC 113K when MyVax began 3/1/07, now 121Krrfman <rrfurman@...> wrote:

Denyse,Yes, and no. You do qualify as refractory because your disease returned quickly, but it does not sound as if you received a full course of Campath. If someone has persistent lymphadenopathy and negative four-color flow of the peripheral blood, it is not a CR because of the lymph nodes. It is unclear why many physicians are using the four color flow in the peripheral blood to follow disease. Thus, the rapid increase off treatment might be just because your disease is not being adequately treated.Addtionally, you have not received fludarabine as of yet. Fludarabine (or pentostatin) remain the mainstay of treatment for all patients. The term refractory is of less importance when someone has not been treated with fludarabine.The Humax-CD20 trial requires patient to be refractory to fludarabine and treated with Campath or refractory to fludarabine and have bulky lymph nodes,

which would indicate a low likelihood of responding to Campath. You do not qualify for the Humax trial because (fortunately!) you do still have excellent treatment options.Rick Furman, MD> > > Thank you for your prompt reply. I am in Las Vegas. It was your thought on > HuMax some months ago that prompted me to discuss this with my Dr. here. I > have had Rituxan and Campath previously so he couldn't find a trial that I would > qualify for with HuMax.> > Have you done any steroids at lower doses that you feel have worked well and > if so, would you be willing to share what you think would be a good amount > to start with? Do you think we are on the right track here? I have no other > symptoms other than a climbing WBC at last apt. was 79k. Feeling good

> otherwise. > > Thanks again,> Denyse> > In a message dated 1/7/2008 11:16:25 A.M. Pacific Standard Time, > _rrfurman@...@me_ (mailto:rrfurman@...) writes:> > > Denyse,> > > > > > > > > > > The use of steroids is often "cookbook", with each physician doing what they > are comfortable with. The steroids are cheap and should not be an issue > with insurance.> > > Humax-CD20 will not be availble out of clinical trials for probably 18-24 > months, but it is availble at many centers on trial right now. Where are you?> > > Rick Furman> > > Re: Steroid Treatment and HuMax > > > > Hi Everyone, > > > > > > Wishing a Happy New Year and a 2008 full of good health to > > > everyone! I have > > > a couple questions I need help with. Is anyone aware of a steroid > > > treatment > > > that has been used successfully to bring the nodes down and is > > > NOT as strong as > > > the HDMP? My Onc. wants to treat with steroids to get the nodes > > > down prior > > > to using Rituxan to clear out the marrow and blood. He says we > > > need a protocol > > > that has been reviewed because although we could come up with our > > > own, he > > > does not think the insurance will cover it. > > > > > >

Additionally, does anyone know when HuMax will be available in the > > > US? How > > > would I find this out? I have heard this is good on large nodes > > > also and of > > > course less toxic than other treatments but I cannot find out when > > > I might be > > > able to get this treatment. > > > > > > I appreciate your input on the above and also any other successful > > > > > > treatments anyone has done to bring the nodes down. > > > > > > Thank you, > > > Denyse > > > > > > > > > > > > > > > > > > > > > > > > > > > ************ ************<WBR>**Start t Easy ways to stay in

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