Small lymphocytic lymphoma treatment - Any idea on IVC or conventional treatments.

	Asked by Unregistered on Thu 20, Mar 2008 04:35am :
	I was diagnosed w/small lymphocytic lymphoma 8/04; treated with Fludarabine & Rituxan from 12/05 - 5/06. Key symptoms are swollen lymph nodes at neck, armpit, groin, pelvis, mostly on right side; otherwise feel fine. Will likely need treatment again within a few months. I've been taking intravenous vitamin C (75g twice per week) with no apparent effect on nodes, though my white blood count has risen from 2.8 to 4.5; also, lymphocytes had been on rise before IVC, last checkup (3/10/08) showed them decreasing slightly (from 48% down to 45%). Any thoughts on effectiveness of IVC. ? Any ideas on recommended conventional treatments? I have just a trace of cancer in my bone marrow, so I'm not sure if stem cell transplant is recommended. Thanks.
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	Answer by Dr Heinrik M, MD (doctor) on Fri 21, Mar 2008 02:11am: Hi, There is no specific evidence pointing to the efficacy of Vitamin C. There are reports of improved responses, but these studies are pretty small (meaning only a few participants – and so estimating how applicable the treatment is to a larger population cannot be done) to make a recommendation to support its routine use. If you choose to continue your treatment now, it would be a good idea to undergo screening for Glucose-6 Phosphate Dehydrogenase (G6PD) deficiency, in order to prevent complications with the blood. There are other chemotherapy options after Fludarabine and Rituximab, however, since cure is not achieved with standard treatment – participation in a clinical trial would be recommended. Stem cell transplant is currently not routine and is usually performed under a trial setting. Best candidates are those who achieve complete response (all traces of the lymphoma is eliminated during the initial therapy).
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