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My lymphoma is resistant to chemo. I refuse to die!
May 3, 2002

I just got out of the hospital yesterday after High dose chemotherapy in preparation for Stem Cell Transplant. My cancer returned within 3 weeks of completing high dose chemo; they told me my cancer has developed a mutation that is multi-resistant to chemo. They said there is a new drug to start clinical trials which may help me. I don't know what its called or anything about it yet. I'm not ready to die. I want to still fight. What else can I try. Please understand I'm 40 and my highest VL was only 5000 and have been undectectable for the past 9 months.Can you offer any insight. I refuse to die. Doctor, I have things I want to do still.Thank you.

Response from Dr. Dezube

This is quite a heart-wrenching query. I appreciate your desire to fight on. Recurrent lymphoma is quite a foe. The situation is NOT hopeless though obviously the battle is a fierce one and there is no guarantee that you will win. What are some options?? If you have a sibling whose bone marrow matches, then you could consider a "mini-allo" transplant. In a "mini-allo", you receive just enough chemotherapy to supress the immune system enough to let your sibling's stem cells to set up shop in your body. These new stem cells will help fight off the cancer. If your tumor has evidence of an EBV (a type of virus) infection, then you could potentially be treated by be given a treatment which would combat EBV-infected cells (your oncologist could probably tell you a bit more about this procedure); chemotherapy can always be given to you. Even if you have "multi-resistant" cancer, sometimes new regimens work. I occasionally use single agent DaunoXome at 100 mg/m2 with good response. Others use the EPOCH regimen (again your oncologist can help you here). There are antibodies designed to target lyphoma. Have these agents been tried?-- some are in wide use, others just got recently approved, and others are in clinical trials. I wish you much luck.


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