Cycle 3, Day 1

UPDATE

Just returned from National Institutes of Health (NIH) in Bethesda, Maryland. I am now beginning my Cycle 3 of my cancer treatment with the experimental drug Ibrutinib (PCI-32765).

LYMPH NODES

According to the CT scan, the largest lymph nodes under my arm pits (there were 15-20 of them) have been reduced to eight enlarged lymph nodes. I had lymph nodes in my abdomen, which are smaller now. The lymph nodes in my neck and clavicle area are also smaller. So this is moving in the right direction. I will receive the full CT scan report in about two weeks.

WHITE BLOOD COUNT (WBC)

In the past month my white blood count has decreased from 135,000 to 110,000. This is good news. Dr. Farooqui told me that the participant who has been in this study the longest has been taking the drug for 8-9 months and he still has not normalized, so don’t be disappointed if I am not. As you recall, normalization of the white blood count is between 3, 500 to 10,000.

Absolute lymphocyte count (ALC) is 104.05 K (normal is 1.18-3.74 K/uL).

BONE MARROW BIOPSY

I will receive the results of the bone marrow biopsy in about two weeks. I will post the results when I get it.

OTHER FINDINGS

My spleen is the same size.

Neutrophils are low at 5.3% (normal = 34-71.1%). Neutrophils are produced in bone marrow and are the body's primary defense against bacterial infection and physiologic stress.

Lymphocytes are 93.8% (normal = 19.3-51.7%).

Monocytes have gotten lower in the past two weeks from 1% to  0.4% (normal = 4.7-12.5%). Time for my B12 shot.

Eosinophils are low at 0.4% (normal = 0.7-5.8%).

These are very helpful in defending the body against parasites.

Eosinophil Absolute is high at 0.44 K/uL (normal = 0.04-0.36 K/uL). Eosinophils become active when you have certain allergic diseases, infections, and other medical conditions, but I do not understand why the Eosinophiils are low and the Eosinophil Absolute count is high. This is a question for my hemotologist/oncologist I see next week.

Basophils are 0 (normal = 0.1-1.2%). Basophils protect the body, killing bacteria and parasites, including external parasites such as ticks. Basophil Absolute is low at 0 (normal = 0.01-0.08 K/uL).

Beta-2-Microglobin is normal at 1.5 mg/L (normal = 0.9-1.7 mg/L).

EXPANDING OUR CLINICAL TRIAL

The last I heard from Dr. Farooqui was that he had met with the drug company on numerous occasions and the stakeholders were NOT going to expand the study. Well the good news is that the drug company changed their mind!

Originally the NIH clinical study had slots for a total of 64 participants (two cohorts -- Cohort A with 32 participants who were over the age of 65, and Cohort B with 32 participants who had 17p deletion, which trumps everything since it is a poor prognosis). The drug company agreed to add six more slots for untreated patients with 17p deletion.

Dr. Farooqui also mentioned that when the drug will get approval (probably in about two years), it will be for relapsed CLL/SLL patients. MD Anderson in Houston and NIH are the sites that are doing studies on untreated 17p deleted patients. More research will have to be done on untreated 17p deleted patients before the drug company approves the drug for them.