What started as a personal journey of a doctor turned patient morphed into a way to share what’s universal in dealing with cancer, in my case a nasty leukemia (CLL), a failed transplant and a successful clinical trial. The telling of my journey has become a journey to teach about CLL, related blood issues and all cancers. Please visit our new website http://cllsociety.org for the latest news and information. Smart patients get smart care™. If you want to reach me, email bkoffmanMD@gmail.com
posted by Brian Koffman at
2:12 PM
BkoffmanMD@gmail.com A family doc and husband of 1 and father of 4 and grandfather of 3 who loves his family and his work. I live with no TV and no microwave, but wouldn't last a minute without friends, art, music, books and the beach. Hockey, good jokes and exotic travel are pretty important too. Writing, Talmud and Zen give meaning to my life. My diet is organic vegan, often raw. I hope the blog makes the load lighter and the path both safer and more fun for those who read it or are going to similar places. I want to help. I crave your comments. If you are new to the blog, check out the portrait my son Will painted (it is the first post), and my very first text post.
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3 Comments:
What to do? What to do?
Three experts give three very different opinions when reviewing the same scenario. This is all too typical of our situation in CLL/SLL.
As you know, I am no expert, but I would be inclined to heed Dr. Rai’s advice. There is every possibility that the transplanted T cells and NK cells destroyed all or most of your malignant B cells last summer and fall before they left the scene. (akin to NK cell infusional therapy).
Given that sophisticated tests have revealed no definite evidence of residual malignant lymphocytes, at worst the disease has been dealt a stunning blow!
If the mesenteric adenopathy represents residual disease, it may or may not become clinically significant over a period of time. If they represent PTLPD, they may regress now that you are off of immunosuppressives or may progress in due course in which case you can treat them with more chemotherapy. If you are completely free of disease, why court trouble?
One thing to consider would be a course of rituximab or Zevalin to eradicate any residual disease or to address the possibility of PTLPD in the mesenteric nodes. Although all treatments carry risk, the risk of this course is likely small.
With what you have told us to date, I would probably not be inclined to do much more than that until it became clear that doing more was necessary. The thought of being off most (if not all) medications and returning to work must be very sweet indeed!
Best of luck,
11qRick
It has been great to catch back up on your journey. Love the good news and to see how G-D continues to lead you in the journey He has for you. We continue to pray for His Shalom in your heart and life as you take the next steps. Looking to the day you will be in the office again in Diamond Bar.
Grace and Peace -
The Barsamian Family - Corona
Dr. K-
Not sure if the last post posted so just wanted to let you know you are in our prayers always and we're excited to see G-D bless you on this journey. We will continue to pray His shalom for you and the family and look forward to the day we see you in Diamond Bar again.
The Barsamian's -
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