Update re ASCT relapse

[Kraskie1915]

Due to my cll returning and having had several new lines of treatment my consultants both my Cll specialist and my transplant specialist have offered me Rchop chemotherapy as one of my few options.

This treatment I believe is not used to treat cll but used to treat lymphomas.

Apparently it has been used in France for cll which I find very interesting !

Wondering if anyone had come across rchop chemo being used to treat cll especially in France as told to me by my consultant.

Started first cycle three weeks ago.

Regards

Michael

Merci bien!!

[HopeME]

I don’t have any answers for you but I’m bumping your question back to the top of the feed hoping someone with a similar treatment history might see your post.

Best,

Mark

[Kraskie1915 in reply to HopeME]

Thank-you mark

[seoul1949]

Yes, I was treated with RCHOP 14 after a experienced a DLBCL. First they thought it would have been a Richters transformation of my CLL from 2013. RCHOP14 was successful, as my Lymphoma disappeared. and, much to my surprise, my MRD, which was slightly increasing since 2014, in 2022 by 5%!, has also disappeared after RCHOP to 0,3%.

All blood counts were normal again, therefore complete remission.

Problem was, after 4th cycle RCHOP I got polyneuropathy and hear problems right ear.

[Skyshark]

It's usually used for Richter's Syndrome transformation, Non-Hodgkin lymphoma.

[Kraskie1915 in reply to Skyshark]

Thanks for info that's nice to know

[Skyshark]

And now there's this.

healthunlocked.com/cllsuppo....

"It should be noted that pathologic diagnosis of RT can be challenging, particularly in patients with TP53-aberrant CLL and those who are progressing on targeted agents, such as BTK inhibitors. In such cases, a main diagnostic confounder can be accelerated CLL, which can mimic RT, but requires a different therapeutic approach (ie, using CLL-directed therapy instead of RT-directed therapy). To be considered RT, the biopsy must demonstrate sheets of large B cells by immunohistochemistry. One retrospective study found that nearly 20% of cases described as RT locally could not be confirmed on central pathologic review, 22 so, when possible, it is encouraged to send a biopsy in a patient with CLL suspected to have RT for pathologic review at a center with specialized hematopathologists. Molecular characterization, including clonal relatedness through IGHV analysis, should be determined whenever possible as this has important prognostic implications (see below)"

"Several of the patients in this study with high SUVs that were concerning radiographically for RT underwent lymph node biopsy and were found to have accelerated CLL.

These patients were then spared undergoing more aggressive CIT regimens used in RT, which are generally ineffective for accelerated CLL, and could instead be treated with standard-of-care CLL-directed therapies, which are recommended for the effective management of accelerated CLL. Thus, the decreased predictive power of PET/CT in the targeted agent era further emphasizes the crucial role that histological diagnosis plays in making a diagnosis of RT."

And the French said don't back in 2014.

"This trial shows that R-CHOP has no role in treating complicated CLL. "

onlinelibrary.wiley.com/doi...

Sorry, best of luck.

[Stewie_1968]

I have read other cases where it's been used successfully so hope it works for you .How are you holding up ?

Stewie