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Week Three

Posted by Frederick Wasti
Apr 05 2012

On Wednesday I went to Dana-Farber for another round of Ofatumumab. It does seem as if the pattern for ~most~ Wednesdays (i.e., each Wednesday that is ~not~ part of the first week of each 28-day cycle) will be approximately as follows:

1. An intravenous line will be established into a suitable vein on one of my hands or arms. (The term "established" is a euphemism for "poked" - <g>.) (The term "suitable" is a bit of a euphemism, too - I really do have crummy surface veins, and getting a line "established" can be a bit of a challenge sometimes - <g>.)

2. A couple of tubes of blood will be drawn immediately and sent to the lab for testing. (It seems that I will likely find out some of the blood test results later in the morning, which is very nice, especially if there are any "good numbers" to be gleaned from the lab results.)

3. I will be given two 500 mg Tylenol/Acetaminophen tablets (I don't know for what - considering what they are doing to me each time I visit there, I can't see how much good two Tylenol tabs could do - <g>) (OK, OK, I guess I have to assume that they're somehow useful for helping prepare me for the Ofatumumab - <g>).

4. I will be given a 50 mg intravenous dose of Methylprednisone, to help prepare me for the upcoming Ofatumumab. (This is quite a different dose from the much larger dose - 2,350 mg - of Methylprednisone that I receive on each of the three days of each first week of each 28-day cycle).

5. I will be given a 25 mg intravenous dose of Benadryl, to help prepare me for the upcoming Ofatumumab. (Previously, I was given 50 mg doses for this purpose, but, since I seem to be tolerating the Ofatumumab so well, the amount of groggy-inducing Benadryl has been mercifully cut back.)

6 And then - finally - I will be given my 1,000 mg dose of Ofatumumab (in 1,000 ml of saline solution). This represents the longest portion of the day at D-F, although the rate of infusion has been "upped" each time I've received it so far, so that this Wednesday did not take as long as last Wednesday as a result.

I mentioned that I do receive some "feedback" in the form of blood test results sometime each Wednesday morning from the blood drawn earlier that morning. (The results may not always be complete due to the time needed to obtain all the results - therefore, the differential results for each individual white blood cell type might be missing, although the total white cell count, the red count, and the platelet count will likely be provided.)

There is some good news: Simply looking at the total white cell count, a couple weeks of Methylprednisone and Ofatumumab have started to turn things around - please note the following graph:

I have emphasized the most recent tests done at D-F for the above graph. March 6th was the day I met with Dr. Fisher at D-F to discuss my treatment options (ultimately deciding for this clinical trial); March 14th was my "screening day", when I qualified for admission into the trial; March 21st was the first day of the trial itself (with the blood being taken for testing before I actually started the treatment); March 28th was during the second week of treatment (showing the results of one week of treatment); and April 4th was from the third week of treatment (showing results from two weeks of treatment).

It can be readily seen that, before treatment started, my white cell count was pretty consistently in the upper fifties (although likely rising slightly each time). However, after one week of treatment, the white count had dropped from the fifties into the upper thirties, and then it dropped even further, to the upper twenties, after a second week of treatment. What's ~not~ to like about that? (<g>)

Of course, there are other blood parameters to consider, too, but the above results do represent an immediate improvement in my blood, and receiving feedback such as this is indeed gratifying. The battle is still being fought (and, in fact, there is still a long road to travel yet), but the numbers are starting to move in the right direction. And so, I ask again, what's ~not~ to like? (<g>)

Categories: Leukemia