Blood counts from 11-th may

[lilica955]

Hy everyone,

My last results :WBC 67.1;LYM 87%;ALC 58;Hb 12.7;PLT 233;only one aria with swollen lymph node (the right size of my neck), small skin infections. My Doc said to prepare for treatment, and ask me my opinion about a monotherapy with Rithuximab.Please yours comments.

Thanks all for a prompt reply.

[AussieNeil Administrator]

Did your doctor say why you should prepare for treatment and why Rituximab monotherapy was right for you? These are the questions I'd be asking (along with how often do you treat CLL patients) and unless there's some very good reason that is not apparent from the information you've provided, I'd be going elsewhere for a second opinion.

Dr Jeff Sharman had a lot to say about Rituximab monotherapy last November:

cll-nhl.com/2014/11/rituxim...

You have an excellent platelet count and your ALC is not a matter for concern, your haemoglobin is a little low, but not seriously so. If you are feeling well, what do you expect to gain from treatment?

Neil

[lilica955 in reply to AussieNeil]

Hi Neil,

Thank you very much for your answer. I had only one time,feb.2009 a single cicle with FC when I become neutropenic for the next 2 months.Until Aug.2010 my lab. blood counts were normal,when ALC began to grow,but doubling time was 18-20 months.Often feel tired now and I deal with minor skin infections. Please let me known your comments.

Thanks again and Best regards!

[AussieNeil Administrator in reply to lilica955]

Lilica, you really need to have the conversation I outlined above with your doctor, plus some additional points below. I'm not medically trained.

Further points for you to think on and discuss with your doctor:

How much is your tiredness interfering with your life? It's a common complaint with CLL and I'd think it would need to be fairly bad to justify treatment. In your shoes, I'd want to have other possible reasons for your tiredness ruled out - and there are many possibilities. You haven't provided your red blood cell count above, but your haemoglobin probably isn't low enough to be responsible for your tiredness and it could very well be due to the CLL.

From what I've read, Rituximab monotherapy is likely to increase your risk of infection, at least in the short to medium term, so I'd also ask your doctor's opinion on that. You may be much better off just finding a way to reduce those skin infections - you say they are only minor.

My concern for you is whether the risks associated with Rituximab monotherapy are going to be outweighed by the rewards. I'll leave you with some more reading, this time from Chaya Venkat four years ago: (in particular, the section Single agent monoclonals)

updates.clltopics.org/3609-...

Neil

[lilica955 in reply to AussieNeil]

Thank you Neil for your very documentated response.Unfortunately,în my country we hematologists for all blood diseases no specialist in CLL. I'll post again when I get a second opinion.

Best wishes.

Lilica