3 ms·

I understand that is similar to any chemotherapy no? But your body will rebuild it after ˜30days.

msla 3y ago
Chemotherapy typically isn't churn-and-burn to that extent, no. I got CAR T-cell therapy after one complete line and a partial line of chemotherapy for Primary Mediastinal B-Cell Lymphoma, a form of Diffuse Large B-Cell Lymphoma. My first line was DA-EPOCH-R, where DA means Dose-Adjusted and EPOCH-R is one letter for each of the specific drugs involved. The drugs are given in multiple 24-hour doses over five days with multiple weeks in between, in a 21- to 28-day cycle. This lasts months, for a total of eight cycles or so. I got an abbreviated second line of R-GemOx, which is three drugs, one of which is oxaliplatin which is, as a platin, substantially more toxic than other chemotherapy agents. That's given over the course of two days for a few hours each day, typically in an infusion center in the hospital as opposed to a hospital bed, with two weeks in between doses. The point is, there's plenty of time and blood tests between rounds of normal chemotherapy. The point isn't to keep you low, it's to bring you low and let you recover for a bit before cycling you through again. They even give colony-stimulating factors, such as Neupogen and Neulasta, to stimulate cell production between rounds, and they give Claritin to prevent the bone pain you might otherwise get from those drugs causing your bone marrow to swell. (The oncologist at MD Anderson was slightly horrified I was even getting R-GemOx and moved me immediately to either CAR T-cell or stem cell transplant; due to an unpromising PET/CT scan I got CAR T-cell therapy. So, no, it isn't last-ditch, but it wasn't first-line when I was sick, at least at the hospital I initially went to. However, the thinking on that might be changing. [1] [2]) Anyway, prior to the CAR T-cell infusion, I got three days of back-to-back-to-back high-dose chemotherapy specifically to destroy my immune system. It was the same drugs, not different drugs in a regimen, and by day three I was definitely feeling it worse than I ever did with DA-EPOCH-R but not as bad as my first round with oxaliplatin, which is the devil and has come to do the devil's work. The damn drug makes cold things feel like they've grown spikes, for crying out loud. How is that even possible? [1] https://ashpublications.org/blood/article/140/Supplement%201/12052/489491/CAR-T-Cell-Therapy-in-First-Line-for-High-Risk https://ashpublications.org/blood/article/140/Supplement%201... [2] https://www.mdanderson.org/newsroom/car-t-cell-therapy-effective-as-first-line-treatment-for-high-risk-large-b-cell-lymphoma.h00-159387468.html https://www.mdanderson.org/newsroom/car-t-cell-therapy-effec...
- polishdude20 3y ago
  When the last round of chemo is given to "destroy your immune system" doesn't it take like 2 weeks to see any signs of immune cells? I knew someone who passed away from leukemia last year because the various infections they contracted in that 2 week window caused irreparable lung damage.
- fnordpiglet 3y ago
  I am glad you are still with us to tell us your story. Thanks.
- dakial1 3y ago
  Thanks for the detailed reply MSLA, and thanks for advanced medicine for you to be still with us!

msla 3y ago

Chemotherapy typically isn't churn-and-burn to that extent, no. I got CAR T-cell therapy after one complete line and a partial line of chemotherapy for Primary Mediastinal B-Cell Lymphoma, a form of Diffuse Large B-Cell Lymphoma. My first line was DA-EPOCH-R, where DA means Dose-Adjusted and EPOCH-R is one letter for each of the specific drugs involved. The drugs are given in multiple 24-hour doses over five days with multiple weeks in between, in a 21- to 28-day cycle. This lasts months, for a total of eight cycles or so. I got an abbreviated second line of R-GemOx, which is three drugs, one of which is oxaliplatin which is, as a platin, substantially more toxic than other chemotherapy agents. That's given over the course of two days for a few hours each day, typically in an infusion center in the hospital as opposed to a hospital bed, with two weeks in between doses. The point is, there's plenty of time and blood tests between rounds of normal chemotherapy. The point isn't to keep you low, it's to bring you low and let you recover for a bit before cycling you through again. They even give colony-stimulating factors, such as Neupogen and Neulasta, to stimulate cell production between rounds, and they give Claritin to prevent the bone pain you might otherwise get from those drugs causing your bone marrow to swell. (The oncologist at MD Anderson was slightly horrified I was even getting R-GemOx and moved me immediately to either CAR T-cell or stem cell transplant; due to an unpromising PET/CT scan I got CAR T-cell therapy. So, no, it isn't last-ditch, but it wasn't first-line when I was sick, at least at the hospital I initially went to. However, the thinking on that might be changing. [1] [2]) Anyway, prior to the CAR T-cell infusion, I got three days of back-to-back-to-back high-dose chemotherapy specifically to destroy my immune system. It was the same drugs, not different drugs in a regimen, and by day three I was definitely feeling it worse than I ever did with DA-EPOCH-R but not as bad as my first round with oxaliplatin, which is the devil and has come to do the devil's work. The damn drug makes cold things feel like they've grown spikes, for crying out loud. How is that even possible? [1] https://ashpublications.org/blood/article/140/Supplement%201/12052/489491/CAR-T-Cell-Therapy-in-First-Line-for-High-Risk https://ashpublications.org/blood/article/140/Supplement%201... [2] https://www.mdanderson.org/newsroom/car-t-cell-therapy-effective-as-first-line-treatment-for-high-risk-large-b-cell-lymphoma.h00-159387468.html https://www.mdanderson.org/newsroom/car-t-cell-therapy-effec...

polishdude20 3y ago
When the last round of chemo is given to "destroy your immune system" doesn't it take like 2 weeks to see any signs of immune cells? I knew someone who passed away from leukemia last year because the various infections they contracted in that 2 week window caused irreparable lung damage.
fnordpiglet 3y ago
I am glad you are still with us to tell us your story. Thanks.
dakial1 3y ago
Thanks for the detailed reply MSLA, and thanks for advanced medicine for you to be still with us!