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Bladder cancer, BCG and 150 T-Cells?
Apr 22, 2007

HI, I have T1, grade 3 bladder cancer, have had two bladder resections, the second of which was clear, and have just started a 6 week course of treament with intravesicle mitomycin-C. We did not use the preferred treatment, BCG, as it is an attenuated vaccine, and everyone consulted was very worried about BCG conbined with 150 T-cells. There is essentially nothing in the literature, so I am now checking practices with large HIV+ caseloads that might have encountered similar situations, just in case the mitomycin-C fails. My last VL was undetectible (below 75), though it is more often around 100. Any experience with similar cases, or anyong you can recommend I check with. By the by, I consulted with Henry Hollander at UCSF's HIV+ clinic, and Shelley M. Greene, another Infectious Disease doc with HIV+ experience. Thanks!

Response from Dr. Daar

I would suggest you talk to an HIV cancer specialist who might have some insight and/or experience. I certainly understand why people would be concerned about giving BCG to someone with CD4 cells of 150 cells/uL since clearly cases of disseminated BCG has occurred. In your favor is that your viral load is undetectable; however, I suspect experience is quite limited.

Best of luck. Eric


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