Re: Collerateral damage by Fludarabine?

[Guest guest]

Yes purine analogs like fludarabine, cladribine, pentostatin, effect T cell

levels...

" Analysis of peripheral blood samples from patients prior and during

fludarabine/cyclophosphamide therapy revealed rapid and sustained reduction of

tumour cells but also of CD4(+) and CD8(+) T cells. "

Source: http://www.ncbi.nlm.nih.gov/pubmed/20857100

More: http://www.jci.org/articles/view/24176/version/1

http://bloodjournal.hematologylibrary.org/cgi/reprint/106/6/2018.pdf

Rituxan depletes cell surface CD20 protein...

See Lin et al. : Anti-CD20 monoclonal antibodies: historical and future

perspectives

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2805725/pdf/0950135.pdf

See: Dr. Hamblin's overview:

http://mutated-unmuated.blogspot.com/2010/08/how-does-rituximab-work.html

Some patients can become refractory to one or both or these treatments.

HTH

~chris

[Guest guest]

Reduced immunity coupled with proliferation of a non-killed cellular moiety

leads to the often rapid re-growth of the disease. Cancer cells are not all the

same genetically, induced death of susceptible cells by the chemo still leaves

cells that are not taken out by the chemicals. Seizing upon the reduced

immunity, these cells often grow with abandon.

[Guest guest]

Collateral damage by chemotherapy (all chemotherapy) refers to cells other than

the CLL cells being damaged by the chemotherapy. Patients who receive

fludarabine will become CD4 lymphopenic for a long time. This means that the T

Helper cells will be killed by the fludarabine and it will put them at risk of

infections. The most notable are PCP pneumonia and shingles. Hence, the reason

for prophylaxis. The CD4 cells might not recover for a very long time (>1

year).

Rick Furman

>

>

> What is the collerateral damage done to the immune system by

> fludarabine, including T cell damage? Is the reason Cll often returns

> at a more aggressive pace than pre Fludarabine, due to damage of T cell

> function? What are other reasons for such aggressive relapses?

>

> Has it been shown that Rituxan (incombination with chemo) is itself

> associsated with collateral damage over time? Has that been studied?

>

> most appreciatively,

>

> Marilyn Barbera

>