|
1996, Jan
|
Original diagnosis of non-Hodgkin’s Lymphoma,
follicular, small cleaved cell type (low grade) most cell
positive for L-26 (CD20) and negative for CD43 and CD45RO
Consistent with a B-cell phenotype (Dr. Daniel A Filippa,
Memorial Sloan Kettering) Bone marrow not involved.
Medical advice: watchful waiting.
|
|
1996, Nov –
1997, Nov
|
Treatment: antineoplastons (trial):
36% reduction at first, then mixed results, finally
lymphoma changed grade and fast progression prompted end of
therapy and start of chemotherapy. Needle biopsy inconclusive
about grade change.
Thyroid nodule identified: Determined to be Hurthle
cell discovered with CT scan while undergoing therapy for
lymphoma.
|
|
1997, Dec-1998, Apr
|
Treatment: CR following six rounds of CHOP therapy
(Cyclophosphamide (Cytoxan), Vincristine (Oncovin), Doxorubicin
(Adriamycin), Prednisone.).
Following CHOP, a gallium scan reported
no sign of lymphoma.
Joint pain prompted a bone scan. Result was negative.
|
|
1998, Sept
|
Thyroid surgery – not NHL-related Right hemi-thyroidectomy performed
by Dr. Fahey – NY Hospital Cornell. Surgery went well;
nodule appeared to be self-contained.
Pathology report: Benign - follicular adenoma, surrounding
thyroid tissue unremarkable.
|
|
1999, Dec
|
Relapse of low grade follicular lymphoma.
Axilla nodes detected in mammogram. Subclavical and neck
node biopsy confirmed diagnosis. (B) We decided to watch
and wait.
|
|
1999, Dec –
2000, Jan
|
Treatment: Rituxan 8x – partial response,
approximately 35% improvement in palpable nodes. No scans
taken. Labs, such as LDH, improved.
|
|
2000, June 22-July 10
|
Treatment: Anti-cd22 (hLL-2) 4x (trial) – No bone
marrow involvement detected prior to treatment. Stable disease.
|
|
2001, Feb 5
|
Lymph node resection for Idiotype vaccine. Large 8x12
axilla node. May have caused Lymphedema in left arm.
|
|
2001, Mar 29
|
Treatment: Started Rituxan 4X once weekly, completed
April 20, 2001, with plan to add oral low dose chemotherapy if
needed. Significant pleural effusion and additional progression
prompts treatment.
|
|
2001, April 12
|
Thoracentesis to remove fluid from around one lung.
Nearly 2 liters removed. Probably caused by enlarged lymph node
pressure on thoracic duct.
|
|
2001, April 14-
July 1
|
Treatment: Daily low dose oral PEP-C (one week
overlap with Rituxan). Switched to every other day on May
16. Ended this course July 1 with very good response--80
to 90% regression. PEP-C: Prednisone, Etoposide,
Procarbazine, and Cytoxan
|
|
2001, Aug 1
|
Removed Hickman Catheter. Dr. F noticed dark irregular
mole and recommended it be checked out.
|
|
2001, Sep
|
Pre-melanoma mole removed surgically by Dr. G. Margins
okay.
|
|
2002, Dec 1 -
Dec 31
|
Treatment: Daily low dose oral PEP-C with very good
response--80 to 90% regression. PEP-C: Prednisone,
Etoposide, Procarbazine, and Cytoxan (Used fish oil and Whey
protein).
|
|
2002, April - Sep
|
Treatment: Idiotype vaccine (Favrille) Id+KLH +
GM-CSF 5 of 6 as of Aug 13 Stable so far
|
| 2002,
Nov |
Rituxan + CpG (Stable) - clinical trial. |
| 2003,
Jan |
01-03 oral low dose PEP-C (PR-90%) |
| 2003,
Mar |
Inteferon-alpha-2b - hoping to consolidate the
good response to PEP-C and hold off progression for subsequent
vaccine |
| 2003,
July |
Favrille idiotype vaccine (Stable) |
| 2004,
July |
oral low dose PEP-C 4 week + 2 week every other day
(~90% response) bone marrow neg (PCR)
Note: Longer time to next treatment |
| 2004,
Nov |
stem cell harvesting - cytoxan, neupogen
Note: PCR negative in bone marrow and low tumor burden. |
| 2005,
Jan |
Bexxar - goal of treatment to get a durable CR.
Realistic because of low tumor burden, disease still sensitive
to treatment, and no detected bone marrow involvement.
Let's hope. |
| 2006,
Mar |
CR unconfirmed by imaging holding beyond one
year. |
|
Other
Concerns/Goals
|
· Control osteopenia from early
chemotherapy-induced menopause and direct effects of
chemotherapy.
· Taking Zoloft for anxiety |
Need extended referral for Dr. L.
· Screen melanoma periodically.
|
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