Hi Jessica--and Emma's Mom, too!
My Caitlin had ITP for a year before trying Rituxan at age 15. IVIg and WinRho were of little help to her, and though Dex pulses took her counts over 100K most times, it only lasted 3-5 weeks before her counts hit retreatment levels (20-30K). It's an inexpensive treatment, but she paid a high price with side effects. Anyway, she was on these pulses for about 10 months before her Rituxan. She didn't have any more steroids after she started Rituxan, but I'm sure she still had residual levels of Dex! I suspect that over time, the docs noted a pattern of better responses when Dex preceded Rituxan--hence, this new protocol, to see if a more deliberate mix of these meds results in a more positive or predictable response.
Had you tried Dex alone, before this? If so, how was the response?
I pulled out the old calendar to give you a read on Caitlin's response to Rituxan alone:
9/24/02 33K and dropping
9/27/02 Started Rituxan
10/1/02 71K
10/4/02 Second Rituxan; 132K
10/8/02 171K; developed mild pneumonia, treated with antibiotics
10/11/02 Third Rituxan
10/15/02 136K
10/18/02 Fourth Rituxan; 103K
10/22/02 115K
11/5/02 104K
11/12/02 140K
11/26/02 225K.....and she's been in the normal range ever since, almost
eight years now!
I'd like to see a scientific comparison on Rituxan alone and with additional meds, relating counts over 100K to remissions of one year or more. Informally, that's the pattern I've noted for people who've had Rituxan alone...if you hit 100K, you get a year or so of remission.
Since they have you taking Dex too, it's hard to tell how much is the Rituxan, and how much is the Dex, and whether you'll follow the same pattern. Still, yo-yoing at the beginning is quite common, so think positive and aim for high numbers when you make your pre-CBC guess next week! Ann, Caitlin's (23) Mom
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