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MDS after FCR?

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Fludarabine combined with cyclophosphamide will cause further mutations that can

lead to MDS, and perhaps ultimately to AML. This is a tough disease to treat.

Much more research and drugs are needed.

A bone marrow biopsy that looks for chromosomal abnormalities specific for MDS

will give you the answer. Even though I recommend not using FCR until their is

no other option, the risk of MDS after FCR is low.

CLL Transformation to MDS or something else?

Posted by: " laneyrae "

jrwolleat@...

 

laneyrae

Thu Jan 27, 2011 1:13 pm (PST)

I have never posted but now am searching for input on my changing CLL.

I am a 59 year old female; dx in 2000 with 6q deletion; tx 6 cycles

FCR 2004, CR for 3 1/2 yrs, FISH done in 12/2007 revealed 11q and 13q

deletions; pursued SCT summer/2008 & found 3 MatchedUnrelatedDon ors,

decided to wait after evaluating CLL expert opinions; developed ITP

2010, tx HDMP for 5 months(100 mg/day 8/1/2010, tapered to 0 mg

12/30/2010), platelets rose above 100k mid tx but came down with dosage

decrease, experienced many negative steroid side effects; IVIG for

immune system monthly 8/2010 - 1/2011.

In the 4 weeks since completing HDMP for ITP on 12/30/2010, my

neutrophils (2.6k to 1.1k) and lymphocytes (35k to 17k) have declined

significantly in addition to the platelets (53k to 37k). The counts on

12/30/2010 were similar to my counts when I started HDMP. I had a

fever, body aches, fatigue last week which the doctors thought was a

" flu-like " viral infection but only lasted 2 days and ended when

I had a drenching night sweat. I now wonder if it was something else. I

was given Rituxan for the ITP on 1/24/2011. Nplate had been considered

but not used because of anemia (HGB 10.8) (RBC 3.0). I was taken off the

prophylactic Bactrim & Valacyclovir I had been taking during HDMP and a

BMB was mentioned but not yet done. I go back 1/31/2011 to check

bloodwork and see where we go from here.

Sorry for the long post. I am concerned about a possible transformation

of my CLL to MDS or something else. I haven't had neutrophils this low

since FCR & never thought I would be concerned about decreasing lymphs.

I would appreciate any input that can be offered to me about my current

situation and what to do next. I have a CLL specialist and a local

oncologist but this list has opened my eyes to many things that I would

never know to bring up or question.

Jillayn Wolleat

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