Started Arzerra!

To update my situation up to yesterday:

• Bone marrow: packed with small lymphocytes, no sign of Richter's
• PET scan many lymph nodes, no sign of activity suggestive of Richter's
• quite enlarged spleen, easily palpable by even myself, as well as increasing axillary nodes
• whew!
• ongoing need for platelet transfusion once weekly, at least made it 2 weeks between RBC

So from the 2 or 3 options  for treatment my onco team picked Arzerra (ofatumumab) in part because I have already had rituximab 3 times and Campath not so good for nodal disease and has significant immune suppression...

Got the first dose, in slowly increasing amounts by infusion, to total 300 mg, in hospital yesterday. Because of a high rate of infusion reactions, my oncos wanted to do as inpatient. It went well, no reaction, since they load you with steroids, antihistamines and acetaminophen. The problem was the inherent inefficiency in hospital, I arrived at direct admission office at 9, got to the floor, IV in place at 10 AM but did not get premeds until about 1:30 and Arzerra started about 2:30, and finally done at 10PM. Felt good though and elected to go home by my usual train/bus combo, enjoying the exuberance of youth, first the disgruntled Phils fans on the train (another story there, they are having a sucky year), and about 40 teenagers coming from a concert in Camden jammed on the bus. I knew where to stand so got the first seat up front, so could get off easily, home by 12:30, slept like a baby.

Next week dose of Arzerra is 2000mg and I will bend over backward to arrange as outpatient, which since I had no reaction, should be able to convince my oncologists.

Although I had blood work on admission, I forgot to ask for results -- I had profuse bleeding from IV site on removal last night requiring a pressure dressing but no problems today. Since have been requiring platelets once weekly, I will go on Monday and get another count.