Another Rituxan question

[Guest guest]

Thanks to all of you and Dr Furman, who responded to my email about

side effects from either R or steroids. I really appreciate you guys!

I am thinking now that it has got to be from the steroids. I had some

of this before with steroid myopathy and although it isn't quite the

same, it fits the bill pretty well as far as the muscle pain and

weakness. The fatigue is also just part of the way my CLL has been

from the time I was diagnosed with only 8,000 wbc. I could always

find ways to manage with it, but this time I think it is just

exacerbated by the muscle weakness which then makes me tired. I have

no fever or other signs of serum sickness.

Unfortunately my primary hematologist has been severely ill for quite

some time and unavailable since the middle of my standard dose Rituxan

treatment. I am being seen by a young doc who isn't that " up " on CLL

and AIHA. He's a good doc, but a newbie.

Question re Rituxan: my wbc came down very slowly but finally DID

come down to about 17,000 in the 2 months post Rituxan. But now they

are going up again and my spleen is getting bigger. My newbie doc

isn't really good at feeling spleens i think, but I can tell it is

bigger. Half way through Rituxan, it was barely palpable. But now it

appears to be anywhere between 4-6cm. Anyone have this happen? I

know R is not that good at treating CLL and what we were concerned

about was the AIHA, which it DOES seem to have done well at. My

absolute retics are 1.9, just below the 2.0 cutoff for " normal " . The

LDH is ok and bilirubin is very low. My hg is 13, highest in my life.

Just this question of why the wbc are now almost 30,000? Would the

increase in spleen size be related to this? Would the spleen be

capturing more wbc and not releasing them? But then that wouldn't

show up in the blood count would it? Is this increase in wbc anything

to worry about if the AIHA appears under control? Thanks, Carol