Our Doctor and nurses took every precaution to prevent tumor lysis syndrome and it worked. After a week of Allopurinol to reduce Uric Acid and a ton of premeds ranging from Benedryl to others I cannot pronounce, the first day of infusion went rather smoothly. He did experience some minor nausea, which after he said "no big deal", I immediately alerted the nursing staff. Instantly 6 nurses rushed into the room and began assessing his vitals, gave him more premeds, and turned down the flow. His blood oxygen level went extremely low, down to 88. I was told it was due to the heavy dosage of premeds. I was also told that this was a reaction, not TLS. Whatever it was, it needed to be dealt with. The amazing nurse we had was ready to admit him, after completing treatment with a blood oxygen level of 90 but the doctor sent him home since we had an oximeter at home. He ate well, but the blood oxygen levels never got above 95 and was an occasional 91 or 92. Still too low. He went super early the next day for more testing and premeds. The second day passed with the flow of the Obinutuzumab turned up and no reaction at all!
His numbers have improved dramatically
Before treatment
Platelets - 147
Neutrophils - 6.98
Absolute Lymphocytes 256.69
Hemoglobin - 12.5
WBC - 267
Swollen spleen and CT scan showed swollen lymph nodes throughout, more so in the cervical/neck areas.
After week one:
Platelets - 60
Absolute Neutrophils - 5.19
Hemoglobin - 13.2
WBC - 24.3
The doctor is impressed, a dramatic improvement and no TLS.
He is already experiencing reduced swelling of the lymph nodes in his neck and body.
Also, he is feeling muscle weakness, not sure what that's about. If anyone has any clues, please let us know.
He is hydrating a ton to keep his system flushed.
Will continue with updates in the weeks to come! Again many, many thanks to all in this group. It truly takes a village and we are honored to be part of it!