Dr. Furman: Re: Clinical trial CALGB 10404& Treanda

[Guest guest]

Jumping in on this thread...

Dr. Furman - Your thoughts on these related questions would be appreciated:

- Is bendamustine any different from other chemotherapeutics in its longterm

depletion of bone marrow (more severe, less)?

- Is there a relationship between duration of these effects and cumulative dose?

Fred - Do you mind sharing some other information about your treatment?

- Treanda is usually recommended for 6 rounds - do you know why it was

discontinued for you after 4? because of the nodes?

- Were you just taking bendamustine or was it with rituxan? I'm assuming your

treatment was for relapsed CLL...

I'm (obviously) in the middle of treanda/rituxan treatment and had a rough first

round - things seem much much better after round 3 except for some minor

transient peripheral neuropathy - but I'm concerned about longterm effects.

Thank you,

Marietta

> >

> > From: rrfman <rrfurman@>

> > Subject: Re: Clinical trial CALGB 10404

> > Date: May 23, 2010 12:23:53 PM EDT

> >

> > " We know lenalidomide is very effective for CLL, but that it is associated

with tumor lysis and tumor flare. In this trial, the lenalidomide is being give

after chemotherapy, so both tumor flare and tumor lysis will be avoided and the

lenalidomide will hopefully " mop up " the residual CLL cells. " 

Rick Furman,

MD

> > ______________________________________________

> >

> > hi ,

> > I had Treanda in 2008 (4 courses of 75mg/m2)

> > About 2 months after completing these 4 courses,

> > my WBC was 6.7, HbL 13.9, Hematocrit 39, RDW 14.4, Platelet 183, Lymph #2.6

& Neu t#3.5

> >

> > I was then given Revlimid " to mop up " (starting with 10mg) since some nodes,

though having shrunk

> > were still enlarged. There was some " tumor flare " and also bone pain, some

intense muscle cramping

> > & scalp itching that lasted about 10 days and subsided; but the " tumor

flare " by which I mean lymph nodes

> > which were not enlarged before Revlimid continued to be enlarged, and

> > WBC was going up following 4 weeks of therapy and taking a " rest " from the

drug.

> >

> > If Bendamustine was injurious to bone marrow, why would my HgL be higher

after treatment

> > and the RDW lowered to " normal " range?

> > and I wonder what, if anything, was the Revlimid " mopping up " ?

> >

> > Perhaps because I didn't continue with Revlimid at 10mg, but reduced it to

5mg-every-other-day

> > after a hiatus of 6 weeks; was the dosage too weak to be effective?

> >

> > water under the bridge now, I guess....

> >

> > Fred Cantor (NYC)

> >

>