Question For Medical Advisor

[Guest guest]

I was going to ask if you could put

my questions below in front of the group’s medical advisor.

Some background:

·

Diagnosed 2000

·

2002 – 6 months of oral Fludarabine

·

2005/6 – 5 months of Chlorambucil and

Rituximab (10mg a day for 10 days and 375mg of Rituximab once per month)

·

Current blood counts: Hb = 153, Platelets 120,

Whites = 6.5, Neuts = 4.8, Lymphs = 0.9

·

Reasons for undertaking previous treatments:

falling platelets (about 60 on each occasion) and enlarged spleen (about 3 cm

below coastal margin which causes discomfort).

·

Infiltrated bone marrow (last BMB about 60%),

small nodes about 2 or 3 cm’s in the most common places, mutated, ZAP70

negative, CD38 negative, Chromosomes - [(#11 11q22 and 11q23), (#17 –

17p13)] - No deletions.

Question 1

My reason for treatment on both occasions is

that my Platelets fall to unacceptable levels, but my Hb has always remained good,

so my marrow is capable of producing adequate red cells. Do you share the

view that it looks like the spleen is pooling my Platelets, hence the enlargement,

and if I was to have the spleen removed these Platelets would return to the peripheral

blood? There would then be the possibility that I might not need any

future treatment for the reason of failing Platelets?

Question 2

As shown in the following chart, since I

have completed treatment (Feb 06) my Lymphocytes have remained at very low

levels (below 1.0). I believe that I am Lymphopenic (sp). Do you

have any insight into this condition and should I be concerned that these Lymphocytes

are remaining low?

Thank you for your review.

Regards

8 robert@...

8 www.charitydalek.co.uk

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