In this one page overview from Clinical Care Options Oncology March 2015 (free membership), Dr Sharman explains how he categorises fit and otherwise healthy patients into low, intermediate and high treatment risk categories and chooses what he considers is the appropriate treatment for each category:
Of particular note: "Those patients with the most favorable risk profile include those with IgHV-mutated CLL without del(17p) or del(11q) by FISH analysis and without mutations in TP53, SF3B1, and NOTCH1 by sequencing analysis. This subset represents 20% of all treated patients; when treated with FCR the progression-free survival rate in this group at 8 years approaches 70% to 80%. Although many patients with CLL are not suitable for intensive chemoimmunotherapy with FCR, this population likely derives the best outcome with this treatment." (My emphasis)
Personally, I think Dr Sharman would have been disappointed with the minimal discussion his article generated.
Neil
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AussieNeil
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I've just checked my Clinical Care Options profile and bearing in mind that you only have to provide information for the starred fields, in the Degree field I've entered 'Other' and in the Speciality field I've entered 'None'.
Note that in the comments section it states: "Comments are allowed only from healthcare professionals who are registered members of Clinical Care Options." so naturally, I've never left comments.
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Good point, which emphasises the importance of seeing a haematologist (particularly one experienced with CLL) rather than an oncologist when you have CLL...
I agree & appreciate your sharing this. The first thing mentioned when dx'd by 1 Onc/Hem & 2 specialists is "you're lucky you're so young & healthy...". I'm moderate risk & completed 6 months FCR last year. My platelets are higher than they've been in 5 years, a 17.5 cm mass largely dissolved & I feel better than I have in at least 5 years (while dx'd only 3 years ago). I stay away from many online groups now as there is almost a chemo-shaming mantra amongst many, including & esp among those in W&W. It is nice to see evidence that there's some validity to this "old" SOC.
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