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My lymphoma is acting up during chemotherapy!
Jul 22, 2003

I have had 6 treatments for primary effusion lymphoma (PEL) designed by an AIDS oncologist including cytotoxin,etopophos, and vincristine. Doxorubicin not used because of probable resistance due to prior treatment for KS. I very recently began having fevers and fatigue again and my ct shows increased thickening of the pleura. My AIDS oncologist stumped. He considered raising the dosages of my current treatment, but said that would "kill" my blood counts. I'm already taking neupogen and procrit. He is inclined to give me oral VP16 with 2 weeks on and 1-2 weeks off to hopefully slow progression. I am happy enough with this and think it is realistic to start making final arrangements. Friends and family are less accepting of this. I know PEL is very rare and difficult to treat so I am not surprised by this outcome. I would just like to know if you would have any possible suggestions at this point other than the ones presented by my oncologist. Thank you so much for your time now and in the past. Jim

Response from Dr. Dezube

Primary Effusion Lymphoma (PEL) is a very unusual effusion. It is characterized by its ability to cause fluid to accumulate in the lungs and/or belly. Most of the lymphoma, which AIDS patients get, are not primary effusion lymphomas. PEL is indeed a hard lymphoma to treat. What would I suggest. I've used DaunoXome (100 mg/m2) with some success. We have one patient whose PEL went into remission with DaunoXome. Althogh DaunoXome is related to doxorubicin, your lymphoma cells may not necessarily be resistant to DaunoXome. Etophos is quite related to VP16. Although you may get some mileage out of VP16, etophos may confer resistance to VP16. Is you HIV maximally suppressed? If not, can you work with your HIV doctor to get on a regimen to suppress your virus. I wish I had an easy answer for you. My very best to you at this trying time.


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