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Monoclonal Antibody What is this ?

 
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HEATHER
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Joined: 17 Nov 2004
Posts: 24

PostPosted: Wed Dec 29, 2004 2:23 pm    Post subject: Monoclonal Antibody Reply with quote

My husband has developed Refractory disease while being treated for CLL. He needs a bone marrow/stem cell transplant but that cant be done untill his wbc count drops. Currently the count is around 400,000.
This Monday he will start on a Monoclonal Antibody called Campath (Alemtuzumab). We understand this will totally wipe out his immune system. Is there anyone out there who has been treated with this or anyone who can give me any info on it? Thank you, Heather
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leo
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Joined: 23 Sep 2004
Posts: 1575

PostPosted: Thu Dec 30, 2004 12:11 am    Post subject: Re: Monoclonal Antibody Reply with quote

Heather,

I have seen a few patients receive Campath. It is a really immunossuppressive drug. I understand this is probably the only way that he can be bridged to transplant, right ?

You can find some decent info here:
http://leukemia.acor.org/campath.html

best regards,
Leo
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Leonardo F - Webmaster Cancer Forums
Disclaimer: this information is for informational purposes only. It is not medical advice.
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HEATHER
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Joined: 17 Nov 2004
Posts: 24

PostPosted: Thu Dec 30, 2004 8:36 am    Post subject: Monoclonal Antibody Reply with quote

Leo,

Yes, according to the Oncologist this is the only way to get the wbc count down for a transplant.

Leo, I was told by a friend that one doesnt actually develop refractory disease. They are Fludura refractory from the start. Is that your understanding? Also, is it standard procedure to do a FISH test immediatly upon diagnosis?

One more question. Do you think at this point my husbands siblings should be tested to see if any of them are a full match for Peripheral Blood Stem Cell Transplant. Our Oncologist says its to soon and that 'they' will do that wherever he has the transplant done also 'they' will deside what type of transplant is needed.

Thank you Leo, Heather
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leo
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Joined: 23 Sep 2004
Posts: 1575

PostPosted: Thu Dec 30, 2004 1:12 pm    Post subject: allogeneic and autologous BMT Reply with quote

Heather

For an allogeneic transplant (from another person), most centers will take only quite young people, I think 55 is a resonable cut-off. This is because the mortality related to the transplant is quite high, and older people just do not do well after an allogeneic transplant. An autologous transplant is quite a different story. It is also called high-dose chemotherapy, where you essentially collect stem cells from the patient, give the chemotherapy, and give the stem cells back, so there are no complications related to rejection of graft-versus-host disease that we see with allogeneic BMT.

Anyway, I honestly think that there is refractory disease. But Campath may be a good choice, and there is one study that even mentioned combining fludarabine with campath.

Still about the BMT, your family can be tested quickly, so unless there is a real plan to proceed with allogeneic BMT, they do not need to be tested right away.

best regards,
Leo
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Leonardo F - Webmaster Cancer Forums
Disclaimer: this information is for informational purposes only. It is not medical advice.
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HEATHER
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Joined: 17 Nov 2004
Posts: 24

PostPosted: Thu Dec 30, 2004 3:24 pm    Post subject: FISH Test Reply with quote

Thanks for the info Leo. What about a FISH test. Is this test standard procedure at time of diagnosis, before chemo starts? Will this test confirm a person has fludurabine Refractor? Thank you, Heather
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leo
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Joined: 23 Sep 2004
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PostPosted: Thu Dec 30, 2004 6:43 pm    Post subject: Re: Monoclonal Antibody Reply with quote

Heather

FISH stands for Fluorescent In Situ Hybridization, and is a technique that can look for any DNA sequence. So you can look for anything. When you say a FiISH test, you have to ask: for what ? What molecule do you want to target ?

best regards,
Leo
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Leonardo F - Webmaster Cancer Forums
Disclaimer: this information is for informational purposes only. It is not medical advice.
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gigi
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Joined: 03 Jul 2005
Posts: 1
Location: Ohio

PostPosted: Sun Jul 03, 2005 5:51 pm    Post subject: Re: Monoclonal Antibody Reply with quote

Heather, please bear with me, because I am new to computers and have never been on a forum before. I would like to share my experience with Campath with you. I went to Cleveland University Hospital Ireland Cancer Center because I wanted to get into the trial for campath with a autogolous transplant. I was first given propylactic medications as anti viral, anti fungal, and antibacterial, and then given fludara for three months of treatment. I had taken lukeran by mouth up until then and was nervous of IV therapy Confused I did well and was bone marrow clear after this therapy. The doctor wanted to stop there, but I told her that I had come to the large hospital to try to recieve a cure, and I wanted to persue that. I started on coral calcium at that time on the advice of several unrelated friends and family telling me about it in a three day period. I thought it was a nudge from above, and seeing I had had a platelet count below 75,000 for years and years, I was surprised to see it shoot above 135,00 in three weeks, and this was good because I needed a count above 100,000 to get into the trial. I took campath then and had to take benedryl, steroids by pill daily and IV before every treatment. I had allergic reactions to the campath and they would give me more benedryl pushes to stop them. Really, I felt tired more as the treatment progressed and had a terrible time with a poorly placed chest catheter, but I didn"t loose my sence of humor throughout the treatment.[And I can loose my jolly's when things get painful!] I couldn't have the transplant because of not harvesting enough stem cells[through bad medical decisions and treatment] but even though my doctor gave me about eight months to be healthy, I am going on mythird year of no sign of the CLL in September. I had trouble with pneumonia after the treatment, but remember, I had heavy duty cytoxan to try to harvest, so I don't know if I would have been as bad with only the campath. I would not hesitate a moment to have campath again, and it would be, in fact my treatment of choice with the now available choices. I am 52 and have had this since I was 38 and I cannot remember feeling this good or having this much energy. The worst downside for me was the massive weight gain with the steroid. Every time I would start to loose, I would have to have my streoids upped becouse of the lung problems.[I had some previous to the CLL] Small price to pay to feel so good. As for the tests, I think your doctor should order all available staging tests for CLL to be performed on your husband. Cll Topics is a good place to go to find out all of the information you may want to arm yourself with before you talk to your doctor again. If you are seeing a local onco/hemo and they don't want to do the tests, GO TO A CANCER TREATMENT CENTER! The bad part about being treated at a large hospital is being worked on by untrained people who are practicing on you. This caused me some bad experiences, but the high quality of knowledge is worth the trip. You can go there and get their best recommendation and if your local will cooperate, get the treatment at home. I hope I helped you. And I wanted to add a word of advise I recieved. Follow the old transplant guidelines for being careful about infections. The new therapy available gives patients more freedom, but why eat in restraunts, and not wash all fruits and vegies in soap before cooking if it could help? Good luck and GOD BLESS YOU! Very Happy
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