5/29/2007: The Anatomy of Hope


This past Thursday through Monday evening, I was treated at City of Hope (COH) with the chemotherapy regimen hyper C-VAD (cyclophosphamide, vincristine, dexamethasone, doxorubicin) a common main line treatment for mantle cell lymphoma. Based on the VAD (vincristine, dexamethasone, doxorubicin) regimen frequently used in both myeloma and acute leukemia, this regimen incorporates cyclophosphamide at 300 mg/m² every 12 hours for six doses; vincristine 2 mg on days 4 and 11 of each treatment cycle; Adriamycin 50 mg/m² by continuous infusion over 2 days beginning day 4; and dexamethasone 40 mg daily from days 1 to 4 and days 11 to 14 of each treatment cycle.
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As before, the therapy included Rituxan. Patients receive hematopoietic growth factors until recovery. These drugs are alternated with cycles of high dose methotrexate (Folex, Rheumatrex), and high dose cytarabine (Cytosar). This is a very intensive regimen that is difficult to administer and is associated with considerable toxicity.

However, the initial results included a complete response rate of 63% in contrast to 21% in the authors’ previous experience utilizing a CHOP-like regimen which I had at the beginning of my therapy last summer.
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While in the treatment these last 5 days, I had chance to read "The Anatomy of Hope" by Dr. Jerome Groopman and would recommend the book for anyone dealing with life-threatening disease. It is all about his personal awakening from the beginning of his medical training about the role of hope in the treatment and recovery from disease.

Listen to and NPR interview with Dr. Groopman HERE.

On a personal note, Dee Dee and I remain most impressed by the people and the facilities at City of Hope and we are so grateful to now have this referral for the next phase of my treatment, include the allogeneic stem cell transplant that may start at the end of July. I should have at lease one more (maybe two) sessions with the Hyper C-Vad, the next in about three weeks. Because of the stem cell transplant, it is not necessary to obtain full remission, just control of the disease and that appears to be happening. At this writing, I cannot detect a lump in the primary site (under my left ear) that caused this latest round of treatment to be started.

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