Sunday, February 15, 2009

FCR Ain't a Happening Trip Right Now

I'm out of the FCR treatment now because of low counts. This is a problem for many, since fludarabine can damage the marrow. Many people don't get beyond the fourth cycle, the local onc doc says.

As memory recalls a year ago, one famous CLL doc at MD Anderson told me when I got a second opinion, 'younger' patients such as myself (now 58) don't have as rough of a time as older patients do, and I should have no problem completing the full six cycles.

I have had two different courses of therapy before, so that might account for the difficulties I'm having now.

I am going back yet again next week to see if my counts have recovered enough to have the next two cycles, but to be honest, I'm losing interest in FCR.

The problems with fludarabine are legion, and eventually they will sell the drug to clean out wheel bearings only. It's way too hard on the marrow, it is so immunosuppressive that they have to irradiate the blood they give you, for fear that the few stem cells you'd ordinarily (or potentially) get in a transfusion would start re-populating your bone marrow, giving you a bad case of mis-matched transfusion leading to all sorts of problems. That's why, though, it is a good drug to give prior to a stem cell transplant.

The various docs who have opined that FCR could cure CLL are, of course, wrong. When one looks at a survival chart, there is no plateau, no levelling off of the death spiral for CLL patients.

We must look elsewhere for potentially curative regimes. FCR ain't it

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