A few Campath questions

Lars · Post by **Lars** » Thu Jan 01, 2009 11:30 am

Hello All,
As a recent transfer from the Tovaxin trial, I, like some others am considering the Campath trial. Thanks for all the posted info and videos on this site. A few questions; is Campath considered a true re-boot like Revimmune? Unlike Revimmune, I do not hear the term Chemotherapy used to describe Campath and yes I have watched all the videos and have read as much as I can but still wonder exactly what a layman's description would be. And the million dollar question; how many of those here have experienced reversal of disability from Campath? Apologies in advance for asking questions that are surely address on this forum. Sometimes sorting through the massive amount of posts is daunting.
Be Well and Happy New Year,
Lars

Loobie · Post by **Loobie** » Fri Jan 02, 2009 7:51 am

That always confused me too Lars. I know it's a monoclonal antibody like Tysabri and Rituxan, but they obviously work much, much differently. I am interested to the answer you get here as I was also wondering the exact same thing. Some reports from people who got it sound almost like the Revimmune type after effects, but like you I also have never heard it refered to as chemo. I do know that it was made to treat leukemia, so maybe it is chemo. There is an article out there about a golfer named Tony Jackson (Ian posted a link somewhere) where the article is titled something like "chemo drug works to treat MS", or something like that.

raven · Post by **raven** » Fri Jan 02, 2009 9:43 am

Chemotherapy is a very mis-used term. Strictly speaking chemotherapy refers to the use of chemicals that destroy cells. For example cyclophosphamide (Revimmune) is a chemical compound that is used to treat lymphoma and therefore is a chemotherapy treatment. Campath, being a monoclonal antibody is noit strictly speaking a chemotherapy treatment because it is a biological agent rather than chemical.

However... Chemotherapy has commonly been used to denote treatments for the various forms of cancer. Campath was originally developed for the treatment of leukemia so in one sense it may be called chemotherapy.

It should be worth noting that all of these drugs have different safety profiles and side effects. Labelling a drug as chemotherapy or not really is irrelevant when it comes to assessing the drug for either effects or safety.

To answer your questions more specifically Lars:

Revimmune treatment is not a re-boot of the immune system unless it is administered in a very high dose short course. Even then I wouldn't call it a true re-boot unless it is used in AHSCT treatment where the patients marrow is taken, the immune system entirely ablated with drugs and then the marrow re-constituted from the sample.

Short of the 'full blown' AHSCT treatment I belive that Campath and high dose Revimmune are comparable.

HTH

Robin.

p.s. I'm one patient who has regained function after Campath treatment although to me, the complete sessation of relapses and progression is a more important thing.

Lars · Post by **Lars** » Fri Jan 02, 2009 10:17 am

Robin,
Thanks, smokin answer. Hey, am I going to lose my hair, I've been looking for an excuse to shave it.
Lars
PS I thought HiCy was high dose/short course.

raven · Post by **raven** » Fri Jan 02, 2009 10:30 am

Sorry Lars,

Any hair loss is gonna be down to you, Campath won't do it for you

Yep, HiCy is short/high dose but I tried to explain the difference because cyc has been used in smaller doses for many years as an anti-inflammatory in MS. The 're-boot' effect is only due to high doses.

Robin

Lars · Post by **Lars** » Sun Jan 04, 2009 11:05 am

Hey Lou,
I'm sure most here have seen this but I found it to be informative:
http://www.chemocare.com/bio/campath.asp
Lars

Loobie · Post by **Loobie** » Sun Jan 04, 2009 2:02 pm

Thanks dude,

And Robin, that response really cleared up a lot of questions I had about chemo. in general and MAB's more specifically. Thanks!

Lyon · Post by **Lyon** » Sun Jan 04, 2009 4:21 pm

CureOrBust · Post by **CureOrBust** » Sun Jan 04, 2009 5:01 pm

From my (possibly mislead) understanding, Campath leaves you with a compromised immune system, but not completely without one. Whereas HiCy knocks out the entire peripheral immune system. After Campath people can fight off a mild infection, whereas after HyCy, any infection will simply run riot.

Am I wrong?

Lyon · Post by **Lyon** » Sun Jan 04, 2009 7:08 pm

CureOrBust · Post by **CureOrBust** » Sun Jan 04, 2009 11:19 pm

Lyon wrote:The intent of researchers in both camps is complete ablation of the immune system...

I do not think that is the case with Campath. They know it does not induce "complete" ablation of the immune system (and hence the term Monoclonal), and even if you increased the dose, it would be fatal before complete immune ablation (okay, this I pulled out of where the sun don't shine

).

If you read the effects of Campath, they are reduced white blood cell count, not ablation. It is a "targeted" monoclonal immune therapy.

Lyon · Post by **Lyon** » Mon Jan 05, 2009 6:19 am

raven · Post by **raven** » Mon Jan 05, 2009 11:53 am

Lyon,

We actually agree.. The intention of both treatments is ablation of the immune system. The only reason I shied away from calling either treatment a complete re-boot is that the outcome is not guaranteed. If just one B cell remains it can replicate whereas with AHSCT you're pretty much guaranteed a total wipeout and reconstruction. The essence of my statement was that HiCy and Campath are broadly comparable whereas AHSCT is a step further.

Monoclonal simply means that all of the antibodies are direct clones of each other. This means that they are very carefully targeted to a particular antigen (CD52 in the case of Campath). It doesn't mean they are specific to one target for example both T and B cells display CD52 therefore they both get the chop. (Again Lyon we are agreeing).

I'm not sure where the idea that to get ablation would require a fatal dose of Campath comes from. It is given in a lower dose than for Leukemia treatment where total ablation is far more important, however the leukemia dose is far from fatal.

Robin

EDIT:: After a re-read of all the posts.

I have seen the phrase 'reduction in white blood cell count' but only on general descriptive sites. Then it is referred to as a side effect rather than the entire reason for the drug in the first place.

The phrase used in the medical texts and also on the papers given to my GP is 'profound lymphopenia' which basically means your white blood cells have been trashed.

Lyon · Post by **Lyon** » Mon Jan 05, 2009 1:56 pm

k6ristin · Post by **k6ristin** » Wed Jan 07, 2009 8:45 am

After the 3rd Day of campath I had ZERO lymphocytes. But the neutrophils and monocytes stayed intact. They help fight bacteria. Every blood test thereafter (every month it is checked) the neutrophils etc were elevated, I guess working overtime due to the lack of lymphocytes.
By Month 2 I had 3.5 lymphocytes, but normal is 16-46.
The new ones that I have are "abnormal" By last count I think I had around 12.
As mentioned previously I was plagued with constant Upper Respiratory Infections until month 9....was prescribed antibiotics by primary constantly but we all know most colds are viral....
I know there's a ton of posts but I really think it's worth the time to read through them all and get everyone's different opinion and experiences before you sign up for these crazy trials. Best of luck!

(prolonged and sustained suppression of lymphocytes is my favorite & most accurate description in my experience)