Had my 6 week follow-up wth Dr. R today. Things look good.
Bloodwork, as always, was "rock solid." No signs of anemia, no low (or high) white blood cell count.
No new nodes popping up anywhere.
The swelling in the leg looks good to him. He's never measured it or anything, but he thinks it looks like it's a little smaller, a little softer, and a little less red than the last time he saw it. So it seems like maybe the Rituxan kept working even a little bit more, after the CT scan in February.
He was pleased enough to say I could come back in 3 months, rather than 6 weeks, which puts me back on my old schedule.
Before I left, we talked about next steps. I always like to know what's coming next. I asked him about Rituxan maintenance. We had talked about another 4 rounds of Rituxan six months after the first treatment. He said he has mixed feelings about it. Rituxan maintenance has shown some benefit for more aggressive lymphomas when the first treatment was chemotherapy; it tends to extend the benefits of chemo. The benefit for indolent lymphomas, particularly when the first treatment was not chemo, is less clear. It wouldn't be harmful to do more Rituxan -- it just might not do any good. He said he was going to think about it, and then made the appointment for two and half months rather than three, so if we did do more Rituxan, we could fit it in before the fall semester starts.
If it was up to me -- and, really, let's be honest: it is up to me -- I would (will) go with four more rounds of Rituxan this summer. I might have skipped it if I had gotten a complete response the first time, but if I still have some swollen nodes, why not give it a shot? It won't cause any real long-term side effects, and it's very tolerable. Dr R seemed more concerned about inconveniencing me than anything else. I say it's a pretty darn good use of my time, ya know?
So that's where we are: a good visit, with more evidence of success with the Rituxan, and a conversation at the end of June about whether or not to keep watching and waiting, or to try another bit of treatment.
A good visit indeed.
Monday, April 19, 2010
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Happy to hear the favorable news you are receiving post treatment. Have you discussed a Clinical trial that combines two Monoclonal Antibodies? Could possibly be more effective than R alone. I know I did Epratuzimab and R and knock on wood got a CR a year ago. Also, I dont know if it is available in a trial yet or not but look up DXL625, supposed to be R on steroids! I have my Onc keeping an eye on that one for me.
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