[Fwd: [MOL] Lillian - More info on CLL] [02230] Medicine On Line


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[Fwd: [MOL] Lillian - More info on CLL]



Dear William, I guess you are happy with a change of job, moving and all
of that; but we will miss you, think of you and keep praying.  Thanks
for everything and hurry on back, your friend, lillian

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Lillian,
I thought that I might pass some more information along regarding protocols
for CLL.  If you are right, and the MOL line changes major topics from time
to time, this might be important to keep around in the event other CLL
patients, caregivers or family/friends ask questions.

I will be leaving the MOL group for a while as I change jobs, residence, and
internet provider.  I will re-up once settled.

Your description of and the accompanying information sent via MOL on 9/16
was of tremendous help to me in understanding the issues surrounding various
medications and protocols.  I am not sure how you maintain your database of
all of the useful information which you discriminate through this forum, but
keep that post for future reference.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~
CHOP Protocol in treatment of CLL:
Cytoxin
Hydroxym....something (aka Adrimycin)
Oncovin
Prednizone
Typically, the regimen is conducted for up to five sessions over a period of
several weeks with blood testing conducted after each session.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The following is a post received from a family friend who is also a doctor
and has experience, although not her primary discipline, in chemo for CLL:

"""""To address some of the issues you raised, I will explain in the same
order.

1. Prednisone is pretty much standard with lots of chemotherapy regimens.
The major side effects are osteoporosis, diabetes, hypertension and peptic
ulcer disease.  The CHOP regimen has been around for years.  The adriamycin
can be toxic to the heart and they may periodically do MUGA scan to assess.
But it sounds like Dr. Schwartz has hit the maximum dose on this anyway.

2.  Treatment options. The Rituxan is the very best bet since it utilizes a
totally different form of attack on the cancer.  It has a much higher cure
rate than CHOP and also a higher rate of remission which is probably the
best we can hope for.  Obviously since it is so new, the side effects and
how to handle them are still being studied.  Specialized treatment centers
will only be able to offer experimental drugs that are in testing.  I would
certainly lean to trying the Rituxan under close observation in the hospital
since it has been studied and been found to be effective.  Unless she simply
cannot tolerate the Rituxan, I would hold off on other options.

3.  Role of spleen.  The spleen is part of the hematopoeitic system - the
blood forming system.  It can enlarge and become diseased as a result of the
leukemia/lymphoma.  It has no causative role in the disease and does have
protective functions against infection.  If the spleen starts to cause
additional problems, then it should be removed but I would be surprised if
this happened.  Dr. Schwartz monitors her spleen when he does abdominal exam
and blood work and with the CT scan.""""
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Your post of 9/16:
""""1. The University of Texas M.D. Anderson Cancer Center New CLL
Therapy
[URL: www.mdacc.tmc.edu/~leukemia/flash/new_programs-CLL.html]
New Programs in CLL. NEW DRUGS (COMPOUND 506U78 and
CAMPATH-1H) FOR CLL PATIENTS REFRACTORY TO FLUDARABINE.
Prior to the advent of fludarabine (Fludara),..
Last modified 12-May-98 - page size 8K - in English [ Translate ]

2. The Cancer Group Institute - Chronic Leukemia (CLL & CML)
[URL: www.cancergroup.com/em34.html]
CHRONIC LEUKEMIA. All leukemia comes from blood cells, which
normally function to provide the body's cells with oxygen (red blood cells),
protect them...
Last modified 17-Feb-98 - page size 3K - in English [ Translate ]

3. BMT Newsletter, Issue 38: Treating CLL with BMT
[URL: oncolink.upenn.edu/specialty/chemo/bmt/n...8/treating.html]
About OncoLink. Editorial Board. Sponsors. Printing FAQ. Help. See
Today's OncoTip. Usage Statistics. Virtual Classroom. Abramson Family
Cancer Research...
Last modified 31-Mar-98 - page size 5K - in English [ Translate ]

4. Phase II Study of 9-Aminocamptothecin in CLL
[URL: ww2.med.jhu.edu/cancerctr/hematol/cll9ac.htm]
johns hopkins cancer, leukemia, 9-Amincamptothecin, CLL, most
commonly used regimen for CLL is chlorambucil and prednisone...
Last modified 16-Sep-97 - page size 5K - in English [ Translate ]

5. BMT Newsletter, Issue 38: BMTs for CLL
[URL: oncolink.upenn.edu/specialty/chemo/bmt/n...N38/bmtcll.html]
About OncoLink. Editorial Board. Sponsors. Printing FAQ. Help. See
Today's OncoTip. Usage Statistics. Virtual Classroom. Abramson Family
Cancer Research...
Last modified 1-Apr-98 - page size 8K - in English [ Translate ]

6. Archives of CLL@LISTSERV.ACOR.ORG
[URL: listserv.acor.org/archives/cll.html]
Archives of CLL@LISTSERV.ACOR.ORG. CLL Chronic Lymphocytic
Leukemia. Search the archives. Post to the list. Join or leave the list.
Manage the list (list..
Last modified 31-Jul-98 - page size 4K - in English [ Translate ]

7. ORAL CLADRIBINE AS PRIMARY TREATMENT OF B-CLL
[URL: www.jcojournal.org/abs14_7/0fxx0028.htm]
copy; 1996 by the American Society of Clinical Oncology. Oral Cladribine
as Primary Therapy for Patients With B-Cell Chronic Lymphocytic
Leukemia. By...
Last modified 6-Feb-97 - page size 3K - in English [ Translate ]

8. FLUDARABINE-INDUCED TUMOR LYSIS IN CLL
[URL: www.jcojournal.org/abs16_7/v16n7p2313.html]
169; 1998 by the American Society of Clinical Oncology. Tumor Lysis
Syndrome: An Uncommon Complication of Fludarabine Therapy of
Chronic Lymphocytic...
Last modified 29-Jun-98 - page size 3K - in English [ Translate ]

9. CancerAnswers - Chronic Leukemia (CLL & CML)
[URL: www.canceranswers.com/em34.html]
CancerAnswers provides the latest information on the most effective
traditional and alternative cancer treatments available.
Last modified 21-Jan-98 - page size 4K - in English [ Translate ]

10. FLUDARABINE FOR CLL: 5-YEAR FOLLOW-UP
[URL: www.jcojournal.org/abs15_2/1axx0016.htm]
169; 1997 by the American Society of Clinical Oncology. Treatment of
Refractory Chronic Lymphocytic Leukemia With Fludarabine Phosphate
via the Group C...
Last modified 6-Feb-97 - page size 3K - in English [ Translate ]

11. CLL Resource Guide - 11742
[URL: hosted.ukoln.ac.uk/msc1997/11742/diag.htm]
WELCOME TO MY CLL RESOURCE GUIDE. DIAGNOSIS AND
TREATMENT. CLL is a form of cancer of the blood system and lymph
tissues caused by the over-production of..
Last modified 14-May-98 - page size 6K - in English [ Translate ]""""


Thank you again for your support, useful information, and prayers.
I have great respect for this forum and for the people whom I have come to
know over the past months.  Rest assured that each day my thoughts go to
those who are on this journey and for those who demonstrate such courage in
the fight.
I will be on-line for only the next two to three days.
BILL W








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