Re: [PyrNet-L] CHAT, HEALTH: Lymphoma/Clondike Update

[Joy Mccarron <jemc@monmouth.com>]

Dear David & Nancy,

Maggie and I are pulling for you AND Clondike!!!!!!
                          Joy
-----Original Message-----
From: David P Kintsfather Jr <kintsfat@kutztown.edu>
To: Great Pyrenees Discussion List <PYR-L@APPLE.EASE.LSOFT.COM>
Cc: pyrnet-l@pyrnet.org <pyrnet-l@pyrnet.org>; lgd-l@APPLE.EASE.LSOFT.COM
<lgd-l@APPLE.EASE.LSOFT.COM>
Date: Sunday, January 24, 1999 8:26 PM
Subject: [PyrNet-L] CHAT, HEALTH: Lymphoma/Clondike Update


>Clondike is an 11 year-old Pyr bitch diagnosed with lymphoma back in May.
>We did chemotherapy all summer and she was in complete remission until
>early December.
>
>We have tried two of the basic chemo drugs since she lost the remission
>and she has been able to hold a partial remission for a little over a
>week.  She has, however, shown some rear end weakness that appears
>neurological which our vets think is related to 2 sequential doses of
>vincristine, while the oncologist suspects the cancer as the underlying
>cause.
>
>We have wanted to avoid adriamycin, the most effective chemo agent against
>lymphoma, but one that almost killed Clondike during her first cycle of
>drugs.  We were able to skip it during the 2nd cycle and use a patented
>monoclonal antibody treatment to get 4 months of remission w/o chemo.
>
>This past week Clondike's nodes were swelling at an alarming rate and
>Thursday and Friday she really looked like the cancer was making her feel
>bad for the first time (so far the chemo has caused far more symptoms than
>the cancer).  The oncologist proposed trying a new protocol just developed
>at Ohio State which uses entirely different drugs than the 1st line
>agents.  She said that these drugs are better tolerated by the digestive
>system and don't turn on the MDR (multi-drug response) gene which makes
>the cells immune to future treatments.  I believe the down side is that
>fewed dogs respond to this protocol than the standard one.
>
>The oncologist still feels a protocol involving adriamycin can be given
>safely and would result in a higher probability of attaining a full
>remission, but feels that this alternative protocol may work well and does
>not preclude trying adriamycin in the future.  An additional attraction of
>this new protocol is that it does not include vincristine and none of the
>individual agents appears to be a neurotoxin, so hopefully we won't mess
>up Clondike's rear end function any further.
>
>For the vets out there this is the DMAC protocol employing a cycle of two
>drug combinations given one a week, usually for 5-8 cycles (10-16 weeks).
>The first treatment is dexamethasone, cytosar and actinomycin D.  This
>requires a 4 hour drip.  The 2nd treatment is actinomycin D and melphalan.
>It is just a shot and tablets.
>
>I was pretty nervous about this, but as we got the first 4 hour drip, I
>met a lady who is on the 2nd cycle of the same protocol.  She said her dog
>had no side effects at all and that his nodes had gone down considerably.
>The technician also said she has not encountered major side effects with
>several dogs she has treated.  We elected to use darbazine for nausea
>prevention, the stronger of their basic drugs.  We also got a prescription
>for zofran, a very effective anti-nausea drug that costs $60 a day :(.
>
>The amazing news is that last night, 24 hours after treatment, Clondike's
>nodes were down dramatically!!  With the conventional drugs it usually
>takes 4 days for any effect to be noticable.  This may be a transitory
>effect of the steroid (dex) in the mix, but at this point we'll take any
>response as a positive sign.
>
>We are now more than 48 hours post treatment, the time at which you
>usually see nausea if it is going to develop.  Clondike appears to be
>feeling better (her eyes are brighter) and she ate with great enthusiasm.
>
>I am not expecting any miracle cure, but in the roller coaster ride of
>chemo therapy, I think we may be on an upswing.  I don't know if Clondike
>would be a candidate for another round of monoclonal antibodies if this
>protocol results in a complete remission, but I will ask.  It hadn't
>occurred to me before that this might even be a possibility.
>
>I think we are pretty much out in uncharted territory with this protocol,
>which apparently has only been in clinical use for a month or 2.  I'll
>keep you posted.
>
>David
>
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> David Kintsfather              | PHONE:       (610) 683-4497
> Dept. of Telecommunications    | FAX:         (610) 683-4659
> Kutztown University            | INTERNET:    kintsfat@kutztown.edu
> PO Box 730                     |   "We need not think alike to love
alike."
> Kutztown, PA  19530-0730       |                Francis David
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