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Rituxan
Is there anyone who is or has been treated with Rituxan? My 81 year old mother will be having her 1st of 4 Rituxan infusions next week in an effort to control swollen lymph nodes caused by Non-Hodgkins Lymphoma. I'm hoping that someone/anyone who has experience with this drug can share their insights (pros/cons). Thanks in advance... "i"
My mom goes in tomorrow for her first infusion... I'll post the side effects and results of the process. Thanks again, "i"
It is follicular.
It couldn't be entirely excised as it was too close and deeply embedded in the surrounding nerve tissue.
The oncologist still refers to it as low grade; so, I would assume that that would categorize it as non-aggressive.
I'll inquire about a fine needle aspiration and ask about her BMB.
My mother felt the growth/change which is why she alerted her oncologist. He approximated that it had doubled in size. The CT scan confirmed what could be felt and indicated that there were no other changes.
My mom suffers from hypertension, so maybe that momentary lowering of her BP might not be so problematic.
Thanks again... you've been very helpful and I truly appreciate your time.
It couldn't be entirely excised as it was too close and deeply embedded in the surrounding nerve tissue.
The oncologist still refers to it as low grade; so, I would assume that that would categorize it as non-aggressive.
I'll inquire about a fine needle aspiration and ask about her BMB.
My mother felt the growth/change which is why she alerted her oncologist. He approximated that it had doubled in size. The CT scan confirmed what could be felt and indicated that there were no other changes.
My mom suffers from hypertension, so maybe that momentary lowering of her BP might not be so problematic.
Thanks again... you've been very helpful and I truly appreciate your time.
COMMUNITY LEADER
hello again, let me jump right in:
- which type of NHL? That matters a lot. Is it follicular?
- why are they not surgically excising the groin node? aka debulking before the rituximab
- has that node transformed to a more aggressive type such as MCL or DLBCL? The change in growth rate suggests that. At least ask for an FNA
- staging doesn't mean so much in NHL, since the lymphatic system is a highway throughout the body
- how was her BMB?
- a CT is not necessary to detect doubling in size of such a visible node, so maybe you can teach her to observe changes herself
- it is possible to shrink a node to zero, though a few cells will remain in the body and will resurface sooner or later. There are some ironies: aggressive cancer cells are usually more easily killed. But the ones that do remain have survived the chemo, so they are resistant. That's why you eventually need to switch. Newer monoclonal antibodies are in the pipeline.
- the time until relapse depends on the cells that are still there, it can be months or many years
- eventually the PT is left with resistant cells and the RTX is no longer effective. But that can take many courses.
- the previous pneumonia probably resulted from lowered leukocyte levels. But RTX only lowers lymphocytes. Susceptibility to infection is not as bad as from harsher chemo regimens. Resp & lung are listed as rare here: http://www.rituxan.com/ra/patient/about/safety-info/side-effects/index.xhtml
- BP gets lowered because the cell killing results in release of histamine. It's temporary and they slow the drip when BP gets too low.
- consider some of the complexity: B-cells have a surface protein called CD-20. That's what the RTX (Rituxan) binds to. But some cancer cells have other surface proteins that tell the immune system, "hey, I'm friendly and harmless, don't kill me". I don't mean to introduce irrelevancies, but instead to show that there are many variables per individual.
- some say you can enhance RTX with beta glucans. Maybe yes, maybe no.
Does that help?
- which type of NHL? That matters a lot. Is it follicular?
- why are they not surgically excising the groin node? aka debulking before the rituximab
- has that node transformed to a more aggressive type such as MCL or DLBCL? The change in growth rate suggests that. At least ask for an FNA
- staging doesn't mean so much in NHL, since the lymphatic system is a highway throughout the body
- how was her BMB?
- a CT is not necessary to detect doubling in size of such a visible node, so maybe you can teach her to observe changes herself
- it is possible to shrink a node to zero, though a few cells will remain in the body and will resurface sooner or later. There are some ironies: aggressive cancer cells are usually more easily killed. But the ones that do remain have survived the chemo, so they are resistant. That's why you eventually need to switch. Newer monoclonal antibodies are in the pipeline.
- the time until relapse depends on the cells that are still there, it can be months or many years
- eventually the PT is left with resistant cells and the RTX is no longer effective. But that can take many courses.
- the previous pneumonia probably resulted from lowered leukocyte levels. But RTX only lowers lymphocytes. Susceptibility to infection is not as bad as from harsher chemo regimens. Resp & lung are listed as rare here: http://www.rituxan.com/ra/patient/about/safety-info/side-effects/index.xhtml
- BP gets lowered because the cell killing results in release of histamine. It's temporary and they slow the drip when BP gets too low.
- consider some of the complexity: B-cells have a surface protein called CD-20. That's what the RTX (Rituxan) binds to. But some cancer cells have other surface proteins that tell the immune system, "hey, I'm friendly and harmless, don't kill me". I don't mean to introduce irrelevancies, but instead to show that there are many variables per individual.
- some say you can enhance RTX with beta glucans. Maybe yes, maybe no.
Does that help?
Thank you, Ken...
My main concern is twofold...side effects and the long term effectiveness of the Rituxan.
To give a bit of background... my mother completed 12 cycles of ABVD chemo in 2008 for the treatment of Hodgkins Lymphoma. That series of treatments proved to be successful and thankfully she is still in remission for the Hodgkins Disease. Unfortunately, a swollen lymph developed in her right groin, soon after the completion of chemo. And, a biopsy determined that the swollen lymph was positive for early stage, low grade Non-Hodgkins Lymphoma.
That lymph activity/growth seemed under control. However, a recent CT Scan revealed that the lymph has doubled in size. Her option, at this point, is the Rituxan... of which we know little about. According to the oncologist, the Rituxan can lower her blood pressure; and, while it shrinks the cancerous lymphs, the shrinkage is not permanent... it will grow again... But, that's all he's told us.
My mom suffered a serious bout of pneumonia during chemo that left her with ongoing respiratory issues... mainly, asthma and bronchitis. And, since this is, as you say, a milder form of chemo, are respiratory problems one of the side effects of Rituxan?
Also, since that shrinkage of the lymphs is temporary... how long until growth resumes? I know that time is relative; grades and stages vary... but, are we looking at a matter of months and/or years of dormancy?
Finally, once lymph growth resumes, can the patient take Rituxan again to control/ shrink the lymph growth?
Thank you for your time, "i"
My main concern is twofold...side effects and the long term effectiveness of the Rituxan.
To give a bit of background... my mother completed 12 cycles of ABVD chemo in 2008 for the treatment of Hodgkins Lymphoma. That series of treatments proved to be successful and thankfully she is still in remission for the Hodgkins Disease. Unfortunately, a swollen lymph developed in her right groin, soon after the completion of chemo. And, a biopsy determined that the swollen lymph was positive for early stage, low grade Non-Hodgkins Lymphoma.
That lymph activity/growth seemed under control. However, a recent CT Scan revealed that the lymph has doubled in size. Her option, at this point, is the Rituxan... of which we know little about. According to the oncologist, the Rituxan can lower her blood pressure; and, while it shrinks the cancerous lymphs, the shrinkage is not permanent... it will grow again... But, that's all he's told us.
My mom suffered a serious bout of pneumonia during chemo that left her with ongoing respiratory issues... mainly, asthma and bronchitis. And, since this is, as you say, a milder form of chemo, are respiratory problems one of the side effects of Rituxan?
Also, since that shrinkage of the lymphs is temporary... how long until growth resumes? I know that time is relative; grades and stages vary... but, are we looking at a matter of months and/or years of dormancy?
Finally, once lymph growth resumes, can the patient take Rituxan again to control/ shrink the lymph growth?
Thank you for your time, "i"
COMMUNITY LEADER
and tylenol for possible fever.
They sit in a recliner. You can probably sit with her unless the infusion room is full.
They sit in a recliner. You can probably sit with her unless the infusion room is full.
COMMUNITY LEADER
hi, I happen to know quite a bit about it. It's the mildest chemo possible, though I prefer to think of it as "biotherapy".
Infusion can take a long time, especially the first time. Very, very few people have serious side effects. Make sure she drinks lots of water afterwards so the kidneys can clear.
There might be rash and chills. They give benadryl to try to counter that. Otherwise, she will probably not notice she's had anything.
It does take a while to work. Think of these antibodies as millions of tiny red flags that stick to the B-cells. The flags are signals to the immune system's killing processes: come kill this cell.
What in particular would you like to know?
Infusion can take a long time, especially the first time. Very, very few people have serious side effects. Make sure she drinks lots of water afterwards so the kidneys can clear.
There might be rash and chills. They give benadryl to try to counter that. Otherwise, she will probably not notice she's had anything.
It does take a while to work. Think of these antibodies as millions of tiny red flags that stick to the B-cells. The flags are signals to the immune system's killing processes: come kill this cell.
What in particular would you like to know?
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Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
If they removed some of the tumor, then they'd automatically send it to pathology so an FNA isn't necessary.
If her CBCs have been okay, I wonder if they'd even do a BMB. But I'd really think that a PET is in order. What did that show?
I guess you already do know all about the infusion room from her previous chemo. But here's a little thing I'd thought of when my father was spending long hours there because of the nurses having to slow the drip due to lowered BP: have some coffee to raise the BP to its usual level.
Good luck to your mom.