marcstck wrote:I'm pretty sure I would not be a candidate for Cytoxan therapy any time soon, because of the havoc wrought on my immune system by Rituxan.
I hadn't realized, although I've never read reasons to think that your levels won't eventually return to normal after Rituxan.
I'm admittedly not familiar with the metric system and wasn't 100% sure where 700-1000 mg/m2 dosing level fit in, but due to the time frame I figured the study was a compilation of suppression dosing.
I notice that I was sending mixed messages in that in my next post to Chris I referred to cyclophosphamide as "HDC". Still, my gut feeling is that, if positive results are found from suppression doses, much better results would be found by using higher doses and rebooting, although probably not everyone agrees.
Eventually, my CD 19 levels will return to normal. I see my neurologist on April 4, at which time a find out where my levels are at. If I were to undergo a second round of Rituxan dosing, my levels might not return to normal for years.
I agree that if Cytoxan used as immunosuppressant was effective in treating certain patients, those patients would probably also see benefit from immune system rebooting.
Since SPMS evolves from RRMS, which we know has a significant inflammatory component, I do think that some SPMS patients will see benefit from HiCy therapy. I would expect these patients to be early in that stage of the disease, when enhancement is still commonly seen.
As you know, I believe PPMS to be an entirely different beast. PPMS patients typically show little sign of immune system involvement in the disease. In my specific case, my two lesions have never enhanced, I have never tested positive for O-bands, and multiple attempts at immunosuppression have proved worthless. I'm certain that there is another mechanism at work in the destruction of my nerve cells. It may be mitochondrial, or retroviral, or perhaps vascular, but I'm not of the opinion that my immune system is the primary culprit.
Believe me, if I thought that Cytoxan in any form would be helpful I'd be inserting the lines into my veins myself...