tag:blogger.com,1999:blog-2741672436160438708.post2394852079770451282..comments2024-03-26T12:50:32.070-07:00Comments on Learning from and about cancer (chronic lymphocytic leukemia or CLL) by Dr. Brian Koffman: Dear DanBrian Koffmanhttp://www.blogger.com/profile/13250684684103918493noreply@blogger.comBlogger1125tag:blogger.com,1999:blog-2741672436160438708.post-75647436693920544132010-08-03T04:55:57.003-07:002010-08-03T04:55:57.003-07:00Certainly only Dan and his caregivers know for cer...Certainly only Dan and his caregivers know for certain what dose of corticosteroids he was given along with R & C for his AIHA, but the so-called Rai protocol calls for use of 12 mg of dexamethasone for 7 days with each cycle.<br /><br />While 12 mg of dexamethasone is a 'large' dose of a corticosteroid it is nowhere near the level that is given when HDMP (high dose methtly prednisolone) is employed as at UCSD. In those instances the dosage is 1,000 to 1,500 mg of methylprednisolone or more per day for one or more days.<br /><br />I have noted this "misconception" about high dose steroids frequently when CLL patients and their caregivers post about their therapy. Patients often receive doses of 100mg or so of solumedrol (or equivalent) when they receive rituximab or ofatumumab. To be more correct, this should not be referred to as HDMP. This dose of steroid, especially when given as a single dose, is not that dramatically high and it's effects are relatively short lived.<br /><br />I would be surprised if anyone outside of UCSD would give HDMP along with R and cyclophosphamide outside of any study protocol. The addition of cyclosporine to this would certainly add to the risks of opportunistic infections.<br /><br />Incidentally, Dr. Rai et al eventually published data on more than 8 patients given the so called RCD protocol.<br /><br />Most importantly... Good Luck Dan and remember to always 'look before you leap'<br /><br /><br />Brian's friend RAnonymousnoreply@blogger.com