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First Day of Treatment

Posted by Frederick Wasti
Mar 21 2012

Having been accepted into the Dana-Farber clinical trial, it was now time to actually start the trial - I am to be given treatment for three days this week.

Today I started with a round of intravenous high dose Methylprednisone (HDMP) (which will also be repeated tomorrow and the next day) - this is a steroid that has been used in many cancer treatments.

Methylprednisone - "A synthetic corticosteroid with anti-inflammatory and immunomodulating properties. Methylprednisolone binds to and activates specific nuclear receptors, resulting in altered gene expression and inhibition of proinflammatory cytokine production. This agent also decreases the number of circulating lymphocytes, induces cell differentiation, and stimulates apoptosis in sensitive tumor cell populations."

As I see it, the Methylprednisone will be helpful in reducing inflammation while, at the same time, facilitating the action of the Ofatumumab, the other drug I would be taking in this part of the trial, and may kill some aberrant cells in its own right.

I was then given an intravenous infusion of Benadryl, which I believe is to prevent or at least minimize allergic reactions to the Ofatumumab. While the administration of the HDMP went pretty smoothly, the effects of the Benadryl were profound. I felt like I weighed about 400 pounds and, when I moved, it seemed I was swimming in molasses.

Finally I was given the infusion of the Ofatumumab. This took several hours, and was the treatment that might have caused the most problems.

Ofatumumab - "A fully human, high-affinity IgG1 monoclonal antibody directed against the B cell CD20 cell surface antigen with potential antineoplastic activity. Ofatumumab binds specifically to CD20 on the surfaces of B cells, triggering complement-dependent cell lysis (CDCL) and antibody-dependent cell-mediated cytotoxicity (ADCC) of B cells overexpressing CD20. The CD20 antigen, found on over 90% of B cells, B cell lymphomas, and other B cells of lymphoid tumors of B cell origin, is a non-glycosylated cell surface phosphoprotein that acts a calcium ion channel; it is exclusively expressed on B cells during most stages of B cell development."

Ofatumumab is the first "big gun" in my treatment. Ofatumumab is a "monoclonal antibody" that will directly attack my aberrant lymphocytes. Unfortunately, it is not a perfect "silver bullet", in that it will attack certain other healthy cells, too. But, the fight is on...

I did experience some skin and scalp itchiness during the administration of the Ofatumumab, but that was about it. I was told today, however, that every trial participant receives only a 30% dose of Ofatumumab the first time - next week and thereafter the dose is upped to 100%. We'll see how that goes soon...

Categories: Leukemia