My father's Bcell lymphoma is considered refractory and he now has c-diff infection. He's being treated for both in the hospital for weeks now, with the latest chemo effort being gemzar and cisplatin. any thoughts?

Do you know how he got the infection?

As for Gemzar and cisplatin, I've heard it used before in refractory b-cell lymphoma but there's probably very little data out there to support the combination's efficacy against b-cell lymphomas. Gemzar isn't even FDA approved for lymphoma so the convincing data has to be pretty scant. Cisplatin meanwhile can bring with it some of the nastiest chemo side effects. Coupled with his infection I imagine he's going to be pretty miserable. Have you asked his doctors what data they're relying on to try this combo?

Ross

Hi Ross,
Thanks for your comment. Not sure how he got the infection. He received first cycle of R-DICE at one hospital, and at the nadir of white blood cell counts he got an infection and my mother took him to the ER at a hospital closer by where he was treated for 4 days. He had antibiotics for that (unidentifiable infection at that point) and several days of recuperation at home before getting symptoms of c-diff.

Since I wrote, just in the last couple of days, my father's tumor has been receding, i.e. they no longer see blockage in the small intestine, he's able to drink and eat a bit again, and he's feeling better overall. Kind of miraculous. Day 8 is the second (brief) infusion of gemzar and that's tomorrow. so I'm nervous about days 10 thru 14 when his WBC count will hit bottom again. The doctors had offered this chemo regimen or low dose chemo which they thought would not be enough to fight the aggressive tumor, nonchemo agents, or DO nothing, and my father chose the first option. I know there's no hard data for lymphoma, it's kind of clinical judgment experiment at this point it seems anyway. Well, hopeful at the moment but cautiously so.

nina-
that's good news then, i hope it continues in that direction. the bottom line is that most chemo drugs are used off-label, and an oncologist's experience in his or her practice can often inform these decisions. cisplatin has been around for a long time and has a track record across a wide spectrum of cancers. gemzar, not so much. that said, as this National Cancer Institute page on Gemzar indicates, it was fda approved for ovarian cancer in 2006 when combined with carboplatin, which is a second generation platinum drug, developed with a view towards making a cisplatin analog without as much toxicity.

best of luck,
ross