The Rituxan treatments have been an overwhelming success!
While I haven't taken the time to write a worthwhile update on my current status, I'd like to share with you the flow results from blood taken prior to the Week 5 treament. The flow was negative -- no hairy cells could be detected using the standard FACS, which is sensitive enough to detect 1 hairy in 10,000 mononuclear cells.
The Cladribine/Rituxan one-two punch worked and was the perfect combination of what I needed. I'm very relieved and very grateful to have found Dr. K's trial. I've now completed 7 of the 8 weekly Rituxan treatments. The last treatment went very well and didn't require Tylenol or Benadryl pre-meds (to eliminate undue strain on my liver).
A week prior, the treating nurse gave me my Tylenol pre-meds half an hour before drawing my blood for the chem20 tests, which include my liver enzyme levels. Not surprisingly, both the AST and ALT enzyme levels were about as high as I'd seen in awhile. This week, the AST was back to normal and the ALT was 50% higher than normal, which isn't too bad for me. I had a consult with a hepatologist, who wasn't surprised that in general my enzymes were elevated. It is not uncommon in half of all cancer patients, given the stress of chemotherapy and all the other agents the body is exposed to. I don't know if that generalization applies to Cladribine chemotherapy specifically, but it helped me feel better about my roller coaster enzyme levels.
Based on prior imaging tests, it appears that my liver is somewhat fatty, and the hepatologist seems confident that a better diet and more exercise will likely return the liver to normal. I'll continue to persist at maintaining dietary and physical discipline in hopes that the fatty condition of the liver can be reversed. They are running additional tests, but right now, it looks like I'm just paying the price for prior years' poor diet and some genetic pre-dispositions.