[SPAM:XXXXXXX] Dr. Furman Comment;Re: Chlorambucil+Rituxan

[Guest guest]

,

Every patient and every situation is different. I typically do not

use chlorambucil as my first line agent because I worry about some of its

complications, but it is not clear that fludarabine (my alternative) is

safer. Ultimately, I find fludarabine easier on the patient with

regard to rapidity of response and not having to watch counts as

closely. Chlorambucil does have the advantage of being

gentler.

Every time chemotherapy is administered, it should be with a specific

purpose in mind, such as hemoglobin falling, big nodes, etc. Most

doctors administer it until the patient achieves the best response.

Some will stop once a desired effect is achieved. While on the

chlorambucil, it is most important to follow the platelets and

neutrophils, in order to make sure that the patient is not receiving too

much chlorambucil.

Rick Furman, MD

At 09:04 PM 8/9/2007, you wrote:

,

Can you or Dr. Furman, tell us how many rounds of Chlorambucil are

safe to do, what tests, or what do we need to be looking for with our

Doctor, if they have started us on Chlorambucil when to stop.

Or Does Dr. Furman no longer use Chlorambucil?

>

> Hello Folks -

>

> I wish to express a " patient opinion " on this

treatment.

>

> Yes, it is a benign treatment, more so that some of the other

choices we

> face.

>

> My personal sense, from viewing a very few samples, is that going

on with

> this TX too long could possibly be a mistake. When it fails, as it

inevitably

> does, it may be too late to switch efficiently to another, more

aggressive TX.

>

> I would urge those of you who are on chlor+rit to discuss this

issue with

> your docs, and to try to make an intelligent decision about WHEN it

is time to

> abandon chlor+rit and switch to a stronger treatment.

>

>

>

>

>

> ************************************** Get a sneak peek of the

all-

new AOL at

>

http://discover.aol.com/memed/aolcom30tour

>

[Guest guest]

Thank you Dr. Furman

wrote:

>

> ,

> Every patient and every situation is different. I typically do not

use

> chlorambucil as my first line agent because I worry about some of

its

> complications, but it is not clear that fludarabine (my

alternative) is

> safer. Ultimately, I find fludarabine easier on the patient with

regard to

> rapidity of response and not having to watch counts as

> closely. Chlorambucil does have the advantage of being gentler.

>

> Every time chemotherapy is administered, it should be with a

specific

> purpose in mind, such as hemoglobin falling, big nodes, etc. Most

doctors

> administer it until the patient achieves the best response. Some

will stop

> once a desired effect is achieved. While on the chlorambucil, it

is most

> important to follow the platelets and neutrophils, in order to make

sure

> that the patient is not receiving too much chlorambucil.

>

> Rick Furman, MD

>

> At 09:04 PM 8/9/2007, you wrote:

>

> >,

> >

> >Can you or Dr. Furman, tell us how many rounds of Chlorambucil are

> >safe to do, what tests, or what do we need to be looking for with

our

> >Doctor, if they have started us on Chlorambucil when to stop.

> >

> >Or Does Dr. Furman no longer use Chlorambucil?

> >

> >

> >

> > >

> > > Hello Folks -

> > >

> > > I wish to express a " patient opinion " on this treatment.

> > >

> > > Yes, it is a benign treatment, more so that some of the other

> >choices we

> > > face.

> > >

> > > My personal sense, from viewing a very few samples, is that

going

> >on with

> > > this TX too long could possibly be a mistake. When it fails, as

it

> >inevitably

> > > does, it may be too late to switch efficiently to another, more

> >aggressive TX.

> > >

> > > I would urge those of you who are on chlor+rit to discuss this

> >issue with

> > > your docs, and to try to make an intelligent decision about

WHEN it

> >is time to

> > > abandon chlor+rit and switch to a stronger treatment.

> > >

> > >

> > >

> > >

> > >

> > > ************************************** Get a sneak peek of the

all-

> >new AOL at

> > >

> >

<http://discover.aol.com/memed/aolcom30tour>http://discover.aol.com/me

med/aolcom30tour

> > >

> >

> >

>