in CLL(Stage-A) after six courses of fludarbine, how much chances of relapse and what are the further treatments if relapse.

[shahid]

my father diagnose CLL (stage -A) in September 2009,his age is 55 years, we take appointment with doctor for treatment and after complete checkup doctor start my father treatment with chemo by using fludarabine , after two courses we take second opinion but other doctors says that you are not need further treatment because now your blood CP reports are normal so u wait and watch but after one and half year CLL relapse and doctor start his treatment again,now we completed six courses of fludara,now me want to know please tell me that how much chances of relapse of CLL(Stage-a) after six course of fludara and what are the further treatments if relapse.

[Newdawn Administrator]

I hope the treatment 'experts' can answer this as it's confused and alarmed me a little.

I hadn't realised a treatment like fludarabine was given at such an early stage of CLL (A) and not as a first line treatment option.

Is this customary?

I'm desperately clinging on to the W & W stage for as long as possible at Stage A (like many on here) and it never occurred to me that this treatment would be suggested at this stage.

In terms of 'staging', how often do physicians actually suggest any form of treatment at Stage A? I'd understood evidence suggested there was little benefit in early intervention. Perhaps there were additional complications?

I'm eagerly awaiting the answers to Shaid's question too.

Newdawn

[hammyj]

I was diagnosed in Nov 2009 and started my fludarabine with cyclophosphomide and rituximab in Jan 2010.

I had large swelling in my glands so I suspect I had had CLL for a while.

(Please ignore the spelling)

[David39]

I'm afraid I don't think there's any way of knowing how long it will be until your father relapses from his latest treatment. CLL is so different in the way if affects people, and how they respond to treatment. There are other drugs available when or if your father relapses again and some new, low toxicity treatments currently being developed which may also be available by then.

I too was treated at Stage A at a point when my symptoms were not troublesome. However, my accelerating lymphocyte count and moderately enlarged lymph nodes and spleen did point to progressive disease which is a treatment indicator.

[MsLockYourPosts Passed Volunteer]

Shahid - How familiar are your father's doctors with CLL? What tests has he had done - Flow Cytometry? FISH? The doctors should be able to tell you what their reason was for starting treatment. It could have to do with rapidly rising counts or other factors like enlarged spleen and lymph nodes, falling platelets or hemoglobin, symptoms like severe fatigue or night sweats. Was fludara used as a single agent? I have not seen that before but it could be something done in other countries (I'm in the US).

No one can give a time to relapse, but if I were you, I would collect copies of all of your fathers records including labs, scans, and doctors's notes. I think it is important to know the reasons for his prior treatments, and to insure that he is being seen by a doctor who is really familiar with CLL. Most oncologists aren't.

[Cllcanada Top Poster CURE Hero]

Fludara oral?... as a single agent or was it chemo cocktail? Perhaps included rituximab and/or cyclophosphamide.

Nobody can even guess on your question... which country are you in? Mono therapy fludara is a rather strange treatment these days frankly...but there may be reasons why it was used... don't know, I'm just a patient.

Need much more information...

[jangreen]

Hi I agree with the other comments. Unless one knows all the medical reasons concerning your father its difficult to say. Has he a heart condition? Most first line treatments these days is FRC. When I asked my consultant when I would need treatment he said it was an art form not a science. However there are main guidelines. A change in blood tests, secondary systoms, enlarged spleen and so on. It may be worth getting a second opinion with a specalist in CLL even if you have to pay privately for it. Good Luck.