Dear Dan

Dan,

Please email at bkoffmanmd@gmail.com and I will try to respond more personally.

Please remember when you comment on my blog, I have NO way to get back to you personally if you don't supply an email. That's why I include mine.

For those who have no idea what this is all about, please read Dan's comment after my prior post.

Dr. Rai's treatment is a mix of three string drugs, all known to have the potential to help both CLL and AHA, so it makes good sense in your case. When you say "salvage therapy" it suggests a need for some heavy lifting to clean out a big tumor burden.

Cyclosporin (CSP) has a very weak record in treating CLL (just some case reports and contradictory in vitro results), and sweet smelling rituximab (R) is the same sweet smelling rituximab in both protocols.

That said it, this much less potent combo of CSP and R than the Rai protocol worked like a champ for me in both controlling my CLL and ITP.

HDMP is a whole other treatment, pioneered by Dr. Kipps.

Dr Rai has a lot of wisdom and experience. I would be tempted to follow his lead.

Like I said, drop me an email and we can take this further.

Stay strong

Brian