R chop

lsmorris20

Hello,

My mom started mini r-chop for her lymphoplasmacytic lymphoma with richters transformation . Her first treatment went ok but she had a reaction to one of the meds which was stopped. Her white blood cell count went from 158 down to 29.5 the day after treatment. The number now is up a bit to 58 a week after treatment. I have no real experience with this type of treatment and am wondering if anyone knows if this is normal. Meaning a rise in the wbc after treatment. The doctor doesn’t seem concerned. I am just worried since she was really sick when she first started treatment with a significantly enlarged spleen and liver. I just am hoping it doesn’t get that bad again before each treatment.

PBL

Your mother's lymphoplasmacytic lymphoma (a.k.a. Waldenstrom macroglobulinemia) required treatment due to transformation. While the chemotherapy ("CHOP") part of her regimen aims to stop the proliferation of rapidly dividing cells (among which the cancer cells), the immunotherapy agent Rituximab specifically targets her mature B lymphocytes, which are the cells affected by cancer. Every round of treatment will more or less completely wipe out those lymphocytes, and your mother's bone marrow will immediately put out new ones to replace them (this can be stimulated by an injection (for example, Neulasta) within a couple of days of each round of treatment). It is therefore to be expected that her white blood cell counts will fluctuate greatly with each cycle.

The Rituximab is very likely what caused the reaction - which is very common for the first infusion and will likely not occur for the subsequent ones.

I hope this answers your questions and helps you relax a bit. Do not hesitate to ask her doctor questions: understanding what is going on not only makes the whole experience less stressful, but can put you in a better position to figure out when something is not right.

Kind regards.

PBL