FCR 6th Cycle and side effects ?

[Penkman]

I have just had my 5th FCR treatment and immediately before this my consultant suggested this would be my last instead of going for a sixth. When I next see him in 3 weeks time he said I will then have another BMB and CT scan to determine if the treatment has been successful. I am 63 years old and have weathered the FCR fairly well although it does make me very tired and lethargic for about 2 weeks afterwards. During the last two cycles I have had to inject myself in the stomach for 5 days from Day 10 as my neotrophyls went down to zero. On this last cycle of treatment, I had a burning and aching sensation in the vicinity of my liver for about the last three days of treatment. My quandary is whether to ask for a 6th treatment to increase my chances of a longer remission. I know the FCR treatment is toxic but do not understand what the effects and dangers of it are. Any advice out there please?

[Cllcanada Top Poster CURE Hero]

Hi Penkman

I suspect the BMB will be used to determine if you have achieved minimal residual disease negativity, aka MRD-, which is the best remission and longest lasting in most cases...

These results and the CTscan will be used to see if the 6th round is required, given your neutropenia. Be certain to bring up the liver issue, it may have bearing on your case, and might require additional tests...

All the best...

~chris

[Penkman in reply to Cllcanada]

Thanks Chris

[Cammie]

Hi

I had only three sessions of FCR and was stopped due to the fact that my bone marrow was not recovering quickly enough.

I too had no nuets actually 0.01 and despite GCSF injections it took 6 weeks for them to recover.

The dangers are that the marrow is damaged irreparably and that would of course mean all blood cells would be affected causing more and more problems.

It is not unusual for patients to have less than the normal 6 sessions depending upon the action and results so far.

The continuation to the 6th round is a trade off between killing off the cll cells to achieve MRD or the treatment causing any irreparable damage.

Remember whilst FCR has given remission and progression free survival of 10 or more years it is still not a cure. So it is likely that at one stage or another the cll may reactivate. The trade off is a simple judgment by you and your medics. Has the treatment been successful and would continuation of the 6th cycle give a longer remission or cause damage to the bone marrow that will affect your life and future possible treatment options.

You must take the advice of your med team in order to make your decision.

Best wishes

Geoff

[Penkman in reply to Cammie]

Thanks Geoff, I understand the trade off issue better now.

[louise66]

Hi,

I only did 5 rounds instead of 6, the reason for me was that with each round I was sicker than the last, also my platelets were dropping very low - they've always been on low side. I decided that I wanted 2 things from treatment - a good remission and to be able to protect my body for future treatments. As Cammie said - this isn't a cure.

I managed to get MRD neg from the 5 rounds, and remission is still holding well - treatment was 2013.

I discussed only doing 5 with my consultant and it was a joint decision, to start with I was disappointed to only manage the 5, but it was the right decision for me. ( In fact in Europe I think 4 is the standard number)

Take care,

Louise

[Penkman in reply to louise66]

Thanks Louise, your comments have helped re-assure me about only having 5 cycles.