tag:blogger.com,1999:blog-19490962.post4654429708893879316..comments2023-12-10T10:06:41.979+00:00Comments on mutations of mortality: Autoimmunity and CLLTerry Hamblinhttp://www.blogger.com/profile/06346629921055055879noreply@blogger.comBlogger6125tag:blogger.com,1999:blog-19490962.post-42394369807114533682011-03-26T02:54:08.102+00:002011-03-26T02:54:08.102+00:00In response to Wayne's comment about CLL and k...In response to Wayne's comment about CLL and kidney disease, I have been diagnosed with glomerulonephritis, kidney disease stage 3 and started my first treatment of any sort for CLL November 2010. I was first diagnosed with CLL in 2006. My oncologist is trying rituxan alone, 4 week treatments every 6 months for 2 years in an attempt to improve kidney function by putting my CLL into temporary remission. I would like to hear from more like us and see what medications are being used.Pamnoreply@blogger.comtag:blogger.com,1999:blog-19490962.post-37324793245900500912011-01-20T10:30:22.853+00:002011-01-20T10:30:22.853+00:00I have written before about non-hemic autoimmunity...I have written before about non-hemic autoimmunity here: http://mutated-unmuated.blogspot.com/2008/09/non-hemic-autoimmunity-in-cll.html As you will see I don't quite agree with Montserrat et al.Terry Hamblinhttps://www.blogger.com/profile/06346629921055055879noreply@blogger.comtag:blogger.com,1999:blog-19490962.post-32206597315880156822011-01-20T00:13:10.282+00:002011-01-20T00:13:10.282+00:00I read through "Haematologica" which you...I read through "Haematologica" which you referenced and in the conclusion the paper states "In most cases, however, there is no a causal link between non-hemic autoimmunity and CLL."<br /><br />I am wondering how wide spread and diverse non-hemic autoimmunity may be? My own family is remarkably free from autoimmune afflictions as well as cancer yet I clearly have CLL being an issue with my kidneys. For three years up until treatment I went from excellent kidney function to moderate damage. After 1st cycle FR the condition became progressively worse, probably from cell lysis and was pushed into stage 4 renal failure by the end of cycle2. <br /><br />Kidney function recovered to a high moderate range and remained stable for 9 months of PR. Interestingly, upon relapse the kidney function began to decline for two months then recovered without intervention to previous stability.<br /><br />I doubt my case is being studied and have encountered or read of others who appear to have other organs "attacked" either directly by CLL or some not well understood autoimmune complication.<br /><br />Thanks for this review as this aspect of CLL is often under the radar.<br /><br />Hope you are getting on well!<br /><br />WWWWaynehttps://www.blogger.com/profile/12333087913528941756noreply@blogger.comtag:blogger.com,1999:blog-19490962.post-63524388257378486562011-01-19T03:48:14.805+00:002011-01-19T03:48:14.805+00:00I have had AIHA (not induced by purine analogues) ...I have had AIHA (not induced by purine analogues) for three years. During that time both rituximab and cyclophosphamide (the former given alone, the latter given as part of the RCD protocol) have controlled the disease for a time. Continued relapse into hemolysis every few months caused me to look for an alternative. I have been on Revlimid now for 10 months and have not had a relapse; my red counts have normalized and I have become Coombs negative. Based on my experience and that of others, Revlimid merits consideration for AIHA control (and it has also managed to control my CLL, which the other protocols were failing to do for very long.) I have written about this in a blog post here:<br /><br />http://clldiary.blogspot.com/2010/10/revlimid-and-autoimmune-hemolytic.htmlDavid Arensonhttps://www.blogger.com/profile/13876562687586184006noreply@blogger.comtag:blogger.com,1999:blog-19490962.post-72074594281576015672011-01-18T23:20:27.034+00:002011-01-18T23:20:27.034+00:00There is evidence that both cyclophosphamide and r...There is evidence that both cyclophosphamide and rituximab are treatments for AIHA. It seems to be the case that both C and R can ameliorate the effect of fludarabine (or pentastatin or cladribine) in causing AIHA. But I am not sure that it would be safe in someone who already had fludarabine induced AIHA and I recommend that it is only introduced after cyclosporine has been used to stabilize the condition.Terry Hamblinhttps://www.blogger.com/profile/06346629921055055879noreply@blogger.comtag:blogger.com,1999:blog-19490962.post-91198940229505142412011-01-18T21:19:01.716+00:002011-01-18T21:19:01.716+00:00In the past you have been steadfast in recommendin...In the past you have been steadfast in recommending against use of fludarabine in patients with a history of AIHA.<br /><br />In the second to the last paragraph you report the findings that patients can perhaps successfully be challenged or rechallenged with fludarabine when used in concert with cyclophosphamide and or rituximab. You didn't really seem to offer your own opinion and i'm wondering if it has changed or not.<br /><br />Also, in your opinion is pentostatin just as likely as fludarabine to be problematic vis-a-vis AIHA?Anonymousnoreply@blogger.com