Thanks PB, that was a busy ASH conference with lots of reading. Well worth while. Much appreciated.
Re CD20, you are on pretty safe ground in saying CD20 is necessary but not sufficient. The simple body count supports you there. Complete or partial responses are indifferent to say the best for Rituxan. Adding I131 [Iodine 131] or Y90 [Yttrium 90] doesn't do the job particularly well either. But without information on the other determinants of Rituxan outcomes, CD20 seems to be the basis for narrowing the hunt. At least you get a lot better efficacy with it than with no treatment and the fatal collateral damage is near zero [isn't it?] so it might as well be poured in along with the cyclophosphamide, vincristine, adriamycin and prednisone. And add some Ascorbic Acid too! As well as cod liver oil and a bunch of retinoids.
I gather from JDai and pals abstract that arsenic trioxide and other chemotherapeutic agents are more effective with ascorbic acid which increases cytotoxic or cytostatic activity.
I read elsewhere about Vitamin E interaction with chemotherapies and the conclusion seemed to be that it didn't seem to stop the efficacy of the treatment, but they were uncertain. That was in the medical school library, but I can't recall the reference sorry.
Variation seems to be the name of the game with the large B-cell non-Hodgkins lymphomas. Single bullets aren't going to work unless a common factor is found.
So early detection, excision, CHOP, Rituxan, I131, Ascorbic Acid, Vitamin E, Retinoids, sleep, exercise, good diet seems to me to be the way to recover from NHL tumors. Comments? Of course, when available, TNT, antiangiogenesis instead of excision, maybe some selective telomerase inhibition. And a nice cup of tea!
Plus don't get it in the first place and choose good parents, while avoiding whatever has caused an 80% increase in the incidence over 25 years.
So IDPH doesn't have it all its own way. Lots of competition for Rituxan and minimal efficacy on its own. But for now, anyone with CD20 might as well be dosing up.
Thanks again for the reference,
Maurice |
