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chemotherapy; am I getting enough
May 3, 2001

Dr Dezube,thank you for your incredible support to people who not only are pos but have cancer as well.Dr how do you know that your getting enough chemotherapy.This my second regieme for NHL last completed IV chemotherapy Adriamycin,cytoxin,vincristine,methotrexate,bleomycin;it was weekly for 3 months.Less than a month after its completion became sick again and sure enough pos gallium and started chemo again,this time oral 7 week cycle for 6 cycles.Cycle 1,3,5 includes CeeNu 200mgs and every cycle includes Etoposide 200mgs x 3 days,cytoxan 200 mgs x10days and Matulane 200mgs x10 days.Is this strong enough to rid me of this once and for all.I worry because my hair has never fallen out and all these drugs are meant to cause hair loss.Not that i am complaining about keeping my hair but just concerned that the chemo isn't strong enough and I am only 37 and want to live.Also i tested pos 3 weeks before i was diagnosed with NHL and had been neg every test prior. My HIV has been well controlled since Sept 2000 undectable VL and CD4 289.Thank you.

Response from Dr. Dezube

I feel for you. It's tough enough getting a diagnosis of lymphoma; it's even tougher being told that the gallium scan is still positive. The regimen you describe (originally pioneered in Cleveland and Albany-- are you in one of those cities?) is a reasonable one. Many oncologists however would treat you at this point with infusional therapy. Infusional therapy entails hospitalizing for a period of a few days, while chemotherapy is infused over a period of time, typcially over 96 hours (such regimens include CDE, EPOCH, and ESHAP). Some oncologists would add Rituxan. Others would follow this up with stem cell transplant (see my answer to a query today on stem cell transplant). It's reasonable to discuss with your oncologists the various options I mentioned, and more importantly to see what (s)he recommends as a means of maintaining your remission, assuming that your disease ulitmately goes into remission Hang in there buddy. BD.


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