Update on how things are going.

Hello everybody,

I just wanted to send a quick update on what's going on with me lately.

First of all, I'm really doing pretty well. I feel, for the most part, normal and am working four days a week in the clinic and am starting to do a little Labor and Delivery work again, for the meanwhile.

Many, but not all of you, know that after testing my siblings we have found that they all match another sibling but nobody matches me, so a bone marrow transplant will not be an option unless we end up looking in a national registry or something.

Plan B is to start some chemotherapy soon. In past years chemotherapy wasn't even considered until one's white count was over about 100,000 (normal being about 10,000). My white count has been steadily climbing since we found I had this disease, but is still "only" 43,000 as of last week.

But there are some new chemotherapies available, the most interesting being the new monoclonal antibodies that selectively attack the abnormal cells, sparing the normal ones. We're going to start therapy on July 22 with a combination of these monoclonal antibodies (called Rituxan) and a new chemotherapeutic drug, fludaribine, and a standard drug, cytoxan. The combination is getting some great reviews from M. D. Anderson and they've found a high percentage of complete remission, at least in relatively short (18 month) follow-up studies. It seems to work best in previously untreated patients with low-grade disease, which definition I fit perfectly.

So I'm actually looking forward to getting started on this regimen. But before we start infusing toxic substances into my bloodstream. Kathy and I are taking a trip to Germany starting next week. We'll be going to a number of places we've never been before. And thanks to upgrade coupons and frequent flier miles, we're going first/business class both ways! We're really looking forward to it.

That's about all for now. We'll keep you updated as things progress.

Later,

Dave