Friday, March 1, 2013

The wild ride continues

As you can see below, the group of nodes on the left side of my neck (on the right by the photo taken with iPhone), there has been rapid growth, with some pain, and my oncology team is now planning on major chemotherapy for this.

There has yet to be any labeling of this a transformation, and maybe that would necessitate a biopsy, but I am to start a course of CHOP-R, which is commonly used in several types of non-Hodgkins lymphoma (NHL) as well as in Richter's transformation of CLL (to diffuse large B cell lymphoma usually). CHOP is

  • Cyclophosphamide, an alkylating agent which damages DNA by binding to it and causing cross-links
  • Hydroxydaunorubicin (also called doxorubicin or Adriamycin), an intercalating agent which damages DNA by inserting itself between DNA bases
  • Oncovin (vincristine), which prevents cells from duplicating by binding to the protein tubulin
  • Prednisone or prednisolone, which are corticosteroids. 
R is for rituximab.Here is a further discussion of the CHOP-R regimen, which includes side effects. And here highlighted in yellow are the results of a phase II German study of R-CHOP showing for those fludarabine-resistant (that would be me) about a 50% response and a 27 month median survival.

My morning bus driver had NHL - now probably "cured" as he is more than 5 years out. Today he noted that he lost all his hair including beard and eyebrows with the same regimen. So in discussion with my wife Cynthia I am going to the barber and going back to my bald look (which I daily maintained by shaving before low platelets made me stop) as well as shave the beard patiently grew on the sides, but keep my goatee until the drugs take it away Here are some photos of my curly locks, soon to be gone:

Look for my projected picture (from a year or more ago) of the return of the shaved old man below, hopefully celebrating success with this next therapeutic adventure . But I am nervous about this therapy yet it seems like the best approach for now....and then on to a clinical trial, perhaps with one or more of the new TKIs (see prior post) or the CART pilot if can clear this node. The one assumed inaccuracy in the pic below is I maintained my goatee....only time will tell....

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