"Oh teachers are my lessons done? Leonard Cohen

I cannot do another one.

They laughed and laughed

and said, Well child,

are your lessons done?

are your lessons done?

are your lessons done?

Leonard Cohen

My teaching on the abstracts from ASH went well. There was much lively discussion on why results in studies done at the fancy universities seem to have consistently higher response rates than those done in community based practices.

None of the answers are comforting. Are the big centers cherry picking their patients? Is care in the community inferior?  In truth, comparing one study to another is bad science. Doses and protocols may vary. Inclusion criteria and patient mix can make big differences in outcomes. Most older studies did not look at the new prognostic factors. Still it is worrisome. MDACC gets a 72% complete response rate and the community oncologists only help 17% of their patients to reach that desired goal with the same drug combo. Something is wrong here.

We also discussed the sad fact that there is still no evidence we are prolonging life in CLL, let alone curing it. Except maybe for a stem cell transplant. Which is why I made that choice. No regrets there. The new drugs reminded me of buying a house with lots of potential. They look so promising. So much potential. And yet the patients aren't living any longer. How's about some realization of all this potential.

HOW ABOUT A CURE!

That would be sweet. 

I will write some straight science soon from my take on ASH, but I will make it bite size and comprehensible.

For a tired guy on disability, I want to share with you just a tiny bit of the "work" I did this week. Forget the doctor's appointments and other commitments.

I reviewed a research project from 2005 on migraines, pulling up old data at the request of principal investigator.

I pulled and reviewed data on the epidemiology of cancer and transplants for my book.

I got copies of my old medical publications, again for my book to impress the potential agents. If they ask why the 30 year gap in publication, I will say I was busy.

I am preparing my writing sample and introduction for the book conference in early Feb.

I reviewed a proposal for a focus group to improve CME (continuing medical education) that I would moderate.

I researched second transplants in CLL. I can't find any papers!

I researched experts in second transplants and DLIs and CLL and began to try to make contact.

I reviewed a joint research proposal with Purdue University that may feature this blog.

I responded to medical questions online from everything from CLL to earwax to contraception. Honest!

I registered for two CME lectures for myself (CLL and gout).

I prepared the lecture for my colleagues in oncology, including getting copies of all the abstracts to them in advance of the meeting.

I also got a new cell phone (my old one died), a new external hard drive for backup (my old one misbehaved) and a new bluetooth speaker (my quite new one was DOA) for the car, all of which had some learning curves and set up hassle.

Who has got time to be sick? 

I may slow down again on the blog for a week as I need to finish some other writing, but I will be back.