12/4/07 IVIG Infusion & Dr Visit

Well, today I had my IVIG therapy* a blood test and my appt with Dr Kipps. I can honestly say that all in all, it was a very good day.

The IVIG was uneventful (3 hours). They took my blood as soon as we got there, and we got the results back after about an hour. My Hemoglobin level has increased to 11.1, which is the highest it has been in over 8 weeks. My last transfusion was last Wednesday and I was at 8.5. Two units should have increased it to 10.5, but over the span of a week, it has always gone back down to lower levels. What this tells us is that I am producing my own red blood cells and I am not Hemolizing (destroying) them. The question now, is whether or not I can produce them on my own unassisted by the Steroids. My WBC was at 173,000, which is down from last weeks 189,000.

Then we had the Dr appt. He is extremely happy with my progress, but is still concerned about me being able to produce my own red blood cells without steroids. He wants to take me off the steroids, but will wait until next week to determine what the timeline should be. (He wants another blood test next week to see where I am). The name of this anemic condition is AIHA or auto immune hemolytic anemia. To show you how serious this is, his quote today was "AIHA if left untreated will kill you, your CLL right now will not". All of my lymph glands have decreased in size and my spleen has shrunk by about 1/2.

After we get the AIHA out of the picture he can begin to once again treat the CLL. He wants to treat me with High dosage Rituxan (a monoclonal antibody treatment not chemotherapy) combined with a PULSE high dose of steroids. I know this is confusing because above I said he wants to get me off the steroids. But this plan would be for a two day extremely high dose of steroids. He thinks that this treatment in my particular situation would give me a Complete Response rate, which effectively puts the CLL in remission (for how long is anyone's guess). He does not want to treat me as this time with Fludura and Cytoxan because those are Chemo drugs which attack the bone marrow and kill both white and red cells. He really wants to keep me away from more transfusions if possible.

All of this is dependent on me being at a stable level for a couple of weeks. At this time I don't know if I will be stable and have the Rituxan treatment before Christmas or not. I am kind of guessing not, but we will see.

I still feel pretty good, just some weakness (probably from the Prednisone), but no shortness of breath. I am even thinking about getting back on the golf course.

Keep those prayers coming in, they are working.

Terry


* Intravenous immunoglobulin (IVIG) is a blood product administered intravenously. It contains the pooled IgG immunoglobulins (antibodies extracted from the plasma of over a thousand blood donors). IVIG's effects last between 2 weeks and 3 months. IVIG is given as a plasma protein replacement therapy (IgG) for immune deficient patients which have decreased or abolished antibody production capabilities. IVIG is administered to maintain adequate antibodies levels to prevent infections and confers a passive immunity. Treatment is given every 3-4 weeks.