To: Bob L who wrote (1532 ) 4/10/1998 10:08:00 PM From: Maurice Winn Read Replies (1) | Respond to of 1762
They didn't steer us towards CHOP. That was the preferred treatment within the medical cartel. Which makes sense to me, but I believe they overestimate the risk of Rituxan as an adjuvant therapy in conjunction with CHOP plus radiation. There is already sufficient evidence to say that Rituxan causes less than 5% mortality due to infections. Tuberculosis is treatable in most cases still and is more a potential threat than a real one right now. In most places anyway. Residual lymphoma risk after CHOP treatment in NHL Stage 1A diffuse, intermediate, large cell, with no risk factors in a 21 year old is still in the realm 10% to 20%. So Rituxan collateral damage is nowhere near that with a likely improvement to 5% to 15% as a wild guess based on the few results so far published. So, to answer your question, no the doctors did not say it would be ineffective - just that there was no evidence that it was. A bit like saying in 1950 that there was no evidence whatsoever that personal computers, cellphones or calculators would be popular. Absence of evidence is not evidence of absence. Since there is no evidence for it, they are unable to use it and because of infection risk, were not prepared to use it anyway. Somewhat a circular argument. The specific infection risk mentioned was tuberculosis by Dr Saven of Scripps who said he had a couple of people suffer tuberculosis after Rituxan. Which makes sense. Especially if they were AIDS patients I suppose - that wasn't mentioned. They didn't even bother with a P53 test to see whether the statistics were further skewed in Tarken's favour or not, although a paper in November Blood showed that it is a significant prognosticator test. As have other papers. I suggested it, but they thought it would not offer any useful information. Maurice