Don Leslie (54+)

Nhl History:
Dx:Aug.95: with Low grade ,follicular lymphoma, stage IVA, B cell, mostly small cells with some large cells, evident in BMT."bone marrow involvement" Completed 8th CHOP early Feb 97. First 3 worked,next 3 did not,hopeful 7 and 8 did. Next catscan early March.
My Que:

I have now had 8 CHOP sessions and thus have reached my limit on Big Red. Sessions 1 to 3 showed a great improvement but 4 to 6 were disappointing. I don't know what 7 and 8 did but will find out after another catscan in March. There is no doubt I will have to start in again in the future - the only question is when.

Does anyone have any idea what drugs are usually used the next time around? I asked my hemDr but forgot which one he mentioned as a possibility if I don't have to start to soon. It started with an F, that is all I can remember. Could it have been Fludarabine. A medication info sheet I have says it is used for "chronic lymphocytic leukemia." Is this the one they have been testing for NHL as well??
Don
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The "F" drug is most probably Flurdarabine. It didn't do much for me when I had it five years ago, but I've heard of others with low grade NHL getting a good response from Fludarabine. The good news is that has many fewer side effects than CHOP. After I had Flurdarabine, I had DHAP (cisplatin + ara-c + decadron), which is definitely heavy duty stuff with more side effects than CHOP.
Barry Wolman
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I'm kind of in the same position as you are. I had a CT scan after my 4th treatment which showed an 80% decrease in size of the mass in my abdomen. Another scan after the 6th CHOP did not show any change at all. So my onc stopped the CHOP. He, and a tumor board, has recommended that I have DHAP chemo and follow that up with a bmt. I told him that I wanted a break and will go back in March for another scan. Since I feel ok I'm not ready to go for the bmt yet. If I knew that would get rid of it, I would do it in a heartbeat. But we all know that's not the case with low-grade NHL. I keep hoping they will come up with a cure soon.
Louise in snowy Annapolis
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From what we went thru, this is not correct. Marcie was stage 4, and only had 6 for her intermediate grade involvement. But there does seem to be quite a bit of leeway and judgement calls that come into play over the course of things.
David
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Along these same lines: I see a variety of CHOP protocols (2-3,4-6,6-8,etc) with sometime no reason for the number. I know stage and cell type have a lot to do with the decision. I would appreciate it if some would write in and give cell type, stage, and the number of CHOP courses recommended.
William
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Fludarabine is the the one I was switched to when CVP wasn't effectituve, and I have lymphoma- low-grade b-cell diffused, It has worked beautifully.
Sylvia
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I was dx with diffuse, small cleaved cell, intermediate grade, stage 3A. 6 rounds of CHOP were applied and I have now been in remission for about 6 months.
John
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Don, yes, they have been testing Fludarabine for NHL for some years now, and i believe it is no longer considered experimental, there having been enough tests to show that it's effective for NHL. I read a short post on the hem-onc list a month or so ago that said it worked best combined with another drug, which i think was Cytoxin... the post said as i recall that 80% of patients treated with this combination showed improvement.
Anne in Chicago