THE WELCH COMPANY
440 Davis Court #1602
San Francisco, CA 94111-2496
415 781 5700
rodwelch@pacbell.net


S U M M A R Y


DIARY: September 25, 2008 08:30 AM Thursday; Rod Welch

Millie 2nd treatment 8th cycle cetuximab Carboplatin 4th relapse IBC.

1...Summary/Objective
...Taxotere Capecitabine 2nd Relapse IBC Treatment After Mastectomy
...Cetuxiab Alone Clinical Study
...Cetuxiab 81 and Carboplatin 14 Treatments Clinical Study 2nd Arm
2...Schedule Weekly Treatments Continue on Thursdays
3...Labs Blood Test
4...Cancer Marker CA 15-3 95 Decreases Over 4 Weeks from 96
5...NEUTS 3.82 Increase 2nd Week Chemotherapy Received
6...Chemotherapy Received Blood Counts Rise Significantly
7...Blood Counts Rise Significantly Chemotherapy Carboplatin Received
8...Neupogen Case Study Missed Carboplatin Treatments Low Blood Counts
9...Side Effects Neupogen Treatments Continue Mild Tolerance Acceptable


..............
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CONTACTS 

SUBJECTS
Cetuximab Carboplatin Clinical Study 2nd Arm 7th Cycle 1st Treatment

1003 -
1003 -    ..
1004 - Summary/Objective
1005 -
100501 - Follow up ref SDS H1 0000. ref SDS G7 0000.
100502 -
100503 -
100504 -
100505 -
100507 -  ..
1006 -
1007 -
1008 - Progress
1009 -
100901 - Background on Millie's treatment in the clinical study is reported on
100902 - 080508. ref SDS A0 TZ8I
100904 -    ..
100905 -   Taxotere Capecitabine 2nd Relapse IBC Treatment After Mastectomy
100906 -
100907 -   Follow up ref SDS H1 X33O, ref SDS G7 X33O.
100908 -
100909 -   Millie had left mastectomy on 051021.  Biopsy at that time reported
100910 -   no findings of cancer.  Approximately 8 months later on 060707 the
100911 -   doctor diagnosed IBC relapse and prescribed treatment with
100912 -   capecitabine and Taxotere, which had been effective in 2005
100913 -   completely eliminating signs of IBC disease. ref SDS 5 PF3O
100914 -
100915 -    1.  Cycle 09 and 01 ................... 060721, ref SDS 6 407N
100916 -    2.  Cycle 10 and 02 ................... 060814, ref SDS 8 LY6O
100917 -    3.  Cycle 11 and 03 ................... 060908, ref SDS 8 407N
100918 -    4.  Cycle 12 and 04 ................... 060929, ref SDS 8 407N
100919 -    5.  Cycle 13 and 05 ................... 061020, ref SDS 9 407N
100920 -    6.  Cycle 14 and 06 ................... 061110, ref SDS 10 407N
100921 -    7.  Cycle 15 and 07 ................... 061201, ref SDS 11 407N
100923 -    ..
100924 -   Cetuxiab Alone Clinical Study
100925 -
100926 -   Follow up ref SDS H1 356I, ref SDS G7 356I.
100927 -
100928 -   After 7 cycles of treatment in 2006, the doctor diagnosed IBC
100929 -   disease was progressing, and so made referral to UCSF for referral
100930 -   in clinical study of Cetuximab and Carboplatin.  Millie was
100931 -   randominzed for treatment with Cetuximab alone, and began weekly
100932 -   treatments at UCSF on 080201.
100934 -                    ..
100935 -                   Total    Cetuximab
100936 -    8.  Cycle 01 and 08 and 01 01.......... 070201, ref SDS 13 SG8I
100937 -    9.  Cycle 01 and 08 and 02 02.......... 070208, ref SDS 14 SG8I
100938 -   10.  Cycle 01 and 08 and 03 03.......... 070215, ref SDS 15 SG8I
100939 -   11.  Cycle 01 and 08 and 04 04.......... 070222, ref SDS 16 SG8I
100940 -   12.  Cycle 02 and 09 and 01 05.......... 070301, ref SDS 18 SG8I
100941 -   13.  Cycle 02 and 09 and 02 06.......... 070308, ref SDS 20 7T3H
100942 -   14.  Cycle 02 and 09 and 03 07.......... 070315, ref SDS 21 7T3H
100943 -   15.  Cycle 02 and 09 and 04 08.......... 070322, ref SDS 22 7T3H
100944 -   16.  Cycle 03 and 10 and 01 09.......... 070329, ref SDS 23 7T3H
100945 -   17.  Cycle 03 and 10 and 02 10.......... 070405, ref SDS 24 7T3H
100946 -   18.  Cycle 03 and 10 and 03 11.......... 070412, ref SDS 25 7T3H
100947 -   19.  Cycle 03 and 10 and 04 12.......... 070419, ref SDS 26 7T3H
100948 -   20.  Cycle 04 and 11 and 01 13.......... 070426, ref SDS 27 7T3H
100949 -   21.  Cycle 04 and 11 and 02 14.......... 070503, ref SDS 28 7T3H
100950 -   22.  Cycle 04 and 11 and 03 15.......... 070510, ref SDS 29 7T3H
100951 -   23.  Cycle 04 and 11 and 04 16.......... 070517, ref SDS 30 7T3H
100952 -   24.  Cycle 05 and 12 and 01 17.......... 070524, ref SDS 31 7T3H
100953 -   25.  Cycle 05 and 12 and 02 18.......... 070531, ref SDS 32 7T3H
100954 -   26.  Cycle 05 and 12 and 03 19.......... 070607, ref SDS 33 7T3H
100955 -   27.  Cycle 05 and 12 and 04 20.......... 070614, ref SDS 34 0001
100956 -   28.  Cycle 06 and 13 and 01 21.......... 070621, ref SDS 35 0001
100957 -   29.  Cycle 06 and 13 and 02 22.......... 070628, ref SDS 36 0001
100958 -   30.  Cycle 06 and 13 and 03 23.......... 070705, ref SDS 37 0001
100959 -   31.  Cycle 06 and 13 and 04 24.......... 070712, ref SDS 37 0001
100960 -   32.  Cycle 07 and 14 and 01 25.......... 070719, ref SDS 38 0001
100961 -   33.  Cycle 07 and 14 and 02 26.......... 070726, ref SDS 36 0001
100962 -   34.  Cycle 07 and 14 and 03 27.......... 070802, ref SDS 37 0001
100963 -   35.  Cycle 07 and 14 and 04 28.......... 070809, ref SDS 39 0001
100964 -   36.  Cycle 08 and 15 and 01 29.......... 070816, ref SDS 40 0001
100965 -   37.  Cycle 08 and 15 and 02 30.......... 070823, ref SDS 41 0001
100966 -   38.  Cycle 08 and 15 and 03 31.......... 070830, ref SDS 41 0001
100967 -   39.  Cycle 08 and 15 and 04 32.......... 070906, ref SDS 42 0001
100968 -   40.  Cycle 09 and 16 and 01 33.......... 070920, ref SDS 43 0001
100969 -   41.  Cycle 09 and 16 and 02 34.......... 070927, ref SDS 44 0001
100970 -   42.  Cycle 09 and 16 and 03 35.......... 071004, ref SDS 45 0001
100971 -   43.  Cycle 09 and 16 and 04 36.......... 071011, ref SDS 46 0001
100972 -   44.  Cycle 10 and 17 and 01 37.......... 071018, ref SDS 47 0001
100973 -   45.  Cycle 10 and 17 and 02 38.......... 071025, ref SDS 48 0001
100974 -   46.  Cycle 10 and 17 and 03 39.......... 071101, ref SDS 34 0001
100975 -   47.  Cycle 10 and 17 and 04 40.......... 071108, ref SDS 49 0001
100976 -   48.  Cycle 11 and 18 and 01 41.......... 071115, ref SDS 50 0001
100977 -   49.  Cycle 11 and 18 and 02 42.......... 071122, ref SDS 36 0001
100978 -   50.  Cycle 11 and 18 and 03 43.......... 071129, ref SDS 53 0001
100979 -   51.  Cycle 11 and 18 and 04 44.......... 071206, ref SDS 54 0001
100980 -   52.  Cycle 12 and 19 and 01 45.......... 071213, ref SDS 57 0001
100981 -   53.  Cycle 12 and 19 and 02 46.......... 071220, ref SDS 60 0001
100982 -   54.  Cycle 12 and 19 and 03 47.......... 071227, ref SDS 61 0001
100983 -   55.  Cycle 12 and 19 and 04 48.......... 080103, ref SDS 62 0001
100984 -   56.  Cycle 13 and 20 and 01 49.......... 080110, ref SDS 65 0001
100985 -   57.  Cycle 13 and 20 and 02 50.......... 080117, ref SDS 66 0001
100986 -   58.  Cycle 13 and 20 and 03 51.......... 080124, ref SDS 67 0001
100987 -   59.  Cycle 13 and 20 and 04 52.......... 080131, ref SDS 69 0001
100988 -   60.  Cycle 14 and 21 and 01 53.......... 080207, ref SDS 73 0001
100989 -   61.  Cycle 14 and 21 and 02 54.......... 080214, ref SDS 74 0001
100990 -   62.  Cycle 14 and 21 and 03 55.......... 080221, ref SDS 37 0001
100991 -   63.  Cycle 14 and 21 and 04 56.......... 080228, ref SDS 79 0001
100992 -   64.  Cycle 15 and 22 and 01 57 01  00... 080306, ref SDS 82 TZ8I
100994 -    ..
100995 -   Cetuxiab 81 and Carboplatin 14 Treatments Clinical Study 2nd Arm
100996 -
100997 -   Follow up ref SDS H1 5B6J, ref SDS G7 5B6J.
100998 -
100999 -   On 080207 doctor reports IBC may be spreading. ref SDS 72 GH5H
101000 -   Follow up examination on 080219 Doctor Rugo diagnosed progression of
101001 -   disease. ref SDS 94 3J4I  Photographs show spread of IBC rash, UCSF
101002 -   prescribed treatment under the 2nd Arm of the study so that Millie
101003 -   now gets weekly treatment with cetuximab and with Carboplatin 3
101004 -   weeks of each 4 week cycle.
101005 -
101006 -             2nd
101007 -             Arm              Cetuximab Carboplatin
101008 -   65.  Cycle 01 15 and 22 and 02 58 02  01... 080313, ref SDS 84 TZ8I
101009 -   66.  Cycle 01 15 and 22 and 03 59 03  01... 080320, ref SDS 85 TZ8I
101010 -   67.  Cycle 01 15 and 22 and 04 60 04  01... 080327, ref SDS 86 TZ8I
101011 -   68.  Cycle 02 16 and 23 and 01 61 05  02... 080403, ref SDS 87 TZ8I
101012 -   69.  Cycle 02 16 and 23 and 02 62 06  03... 080410, ref SDS 90 TZ8I
101013 -   70.  Cycle 02 16 and 23 and 03 63 07  03... 080417, ref SDS 92 TZ8I
101014 -   71.  Cycle 02 16 and 23 and 04 64 08  03... 080424, ref SDS 95 TZ8I
101015 -   72.  Cycle 03 17 and 24 and 01 65 09  04... 080501, ref SDS 98 5B6J
101016 -   73.  Cycle 03 17 and 24 and 02 66 10  05... 080508, ref SDS A0 5B6J
101017 -   74.  Cycle 03 17 and 24 and 03 67 11  05... 080515, ref SDS A1 5B6J
101018 -   75.  Cycle 03 17 and 24 and 04 68 12  05... 080522, ref SDS A2 5B6J
101019 -   76.  Cycle 04 18 and 25 and 01 69 13  06... 080529, ref SDS A5 5B6J
101020 -   77.  Cycle 04 18 and 25 and 02 70 14  07... 080605, ref SDS A6 5B6J
101021 -   78.  Cycle 04 18 and 25 and 03 71 15  08... 080612, ref SDS A9 5B6J
101022 -   79.  Cycle 04 18 and 25 and 04 72 16  08... 080619, ref SDS B2 5B6J
101023 -   80.  Cycle 05 19 and 26 and 01 73 17  09... 080626, ref SDS B7 5B6J
101024 -   81.  Cycle 05 19 and 26 and 02 74 18  10... 080703, ref SDS C2 5B6J
101025 -   82.  Cycle 05 19 and 26 and 03 75 19  11... 080710, ref SDS C5 5B6J
101026 -   83.  Cycle 05 19 and 26 and 04 76 20  11... 080717, ref SDS D1 5B6J
101027 -   84.  Cycle 06 20 and 27 and 01 77 21  12... 080724, ref SDS D8 5B6J
101028 -   85.  Cycle 06 20 and 27 and 02 78 22  13... 080731, ref SDS E2 5B6J
101029 -   86.  Cycle 06 20 and 27 and 03 79 23  14... 080807, ref SDS E8 5B6J
101030 -   87.  Cycle 06 20 and 27 and 04 80 24  14... 080814, ref SDS F4 5B6J
101031 -   88.  Cycle 07 21 and 28 and 01 81 25  14... 080821, ref SDS F6 5B6J
101032 -   89.  Cycle 07 21 and 28 and 02 82 26  15... 080828, ref SDS G4 5B6J
101033 -   90.  Cycle 07 21 and 28 and 03 83 27  16... 080904, ref SDS G5 5B6J
101034 -   91.  Cycle 07 21 and 28 and 04 84 28  16... 080911, ref SDS G7 5B6J
101035 -   92.  Cycle 08 22 and 29 and 01 85 29  17... 080918, ref SDS H1 5B6J
101036 -   93.  Cycle 08 22 and 29 and 02 86 30  18... 080925, ref SDS 0 5B6J
101038 -  ..
101039 - Today is the 2nd treatment of the 8th cycle with cetuximab and
101040 - Carboplatin together.  This is the 30th treatment overall with
101041 - cetuximab on the 2nd arm of the clinical study, but is only the 18th
101042 - treatment with Carboplatin due to low blood counts.
101044 -  ..
101045 - Catherine is out for awhile.  She injured her calf muscle running, and
101046 - is now on crutches.  Sounds like Catherine is following Millie's
101047 - example, injuring her knee while hiking at Lafayette reservoir 2 days
101048 - ago on 080923. ref SDS H3 FN5K
101049 -
101050 -        [On 081023 Catherine recovering from injury. ref SDS H4 UQ6G
101052 -  ..
101053 - Diane is the nurse today.
101054 -
101055 -
101056 -
1011 -

SUBJECTS
Default Null Subject Account for Blank Record

1703 -
170401 -  ..
170402 - Schedule Weekly Treatments Continue on Thursdays
170403 -
170404 - Follow up ref SDS H1 1K7H, ref SDS G7 1K7H. ref SDS G5 1K7H.
170405 -
170406 - The current schedule is listed on 080918. ref SDS H1 PN6F
170408 -  ..
170409 - The schedule for Neupogen is listed on 080929. ref SDS H2 SY8G
170410 -
170411 -
170412 -
170413 -
1705 -

SUBJECTS
Blood Tests Labs Infusion Clinic Evaluate Safe Chemotherapy 1st Trea

2503 -
2504 - 0750
250501 -  ..
250502 - Labs Blood Test
250503 -
250504 - Follow up ref SDS H1 FW5N, ref SDS G7 FW5N.
250505 -
250506 - Adding Carboplatin to the treatment protocol now requires weekly blood
250507 - tests to determine if the immune system is strong enough for safe
250508 - chemotherapy treatment, reported on 070201, ref SDS 13 XR40, and
250509 - citing the clinical study protocol received from UCSF on 070116.
250510 - ref SDS 12 5U7Z
250512 -  ..
250513 - Diane performed the blood draw as shown in the schedule received on
250514 - 080918. ref SDS H1 PN6F
250515 -
250516 -
250518 -  ..
2506 -
2507 -
2508 - 1010
2509 -
250901 - During treatment, Diane submitted results of the test for the 2nd
250902 - treatment in the 8th cycle.  Scope is the same as for the 2nd
250903 - treatment of cycle 7 on 080828. ref SDS G4 075H
250904 -
250919 -     ..
250920 -    Log#:                   080925 08:15
250921 -    <----------------------- U C S F -----------------------> <-------------  Kaiser -------------->
250922 -    Type                 Results   Units        Normal        ACRO   Type            Units        Normal
250923 -     ..
250924 -    CBC with DIFF & PLT CT                                     CBCD
250925 -     ..
250926 -    WBC COUNT               6.5    x10E9/L     3.4  -   10     WBC   WBC x10-3        K/uL     3.4  -  10.0
250927 -    RBC COUNT      L        3.90   x10E12/L      4  -   5.2    RBC   RBC x10-6        M/uL    3.60  -  5.70
250928 -    HEMOGLOBIN             13.1    g/dL         12  -   15.5   HGB   Hemoglobin       g/dL    11.5  -  15.0
250929 -    HEMATOCRIT             38.2    PERCENT      36  -   46     HCT   Hematocrit       %       34.0  -  46.0
250930 -    MCV                    98      fL           80  -   100    MCV   MCV              fL      80.0  -  100.0
250931 -    MCH                    33.4    pg           26  -   34     MCH
250932 -    MCHC                   34.2    g/dL         31  -   36     MCHC
250933 -    PLATELETS             241      x10E9/L     140  -  450     PLT   Plt x10-3        K/uL     140  -  400
250934 -
250935 -        Performed at Mt Zion Clinic Lab, 1600 Divisadero, San
250936 -        Francisco, CA  94115
250937 -    ..
250938 -     (NEUTS x 1000 = ANC for Kaiser)
250939 -    NEUTS                   3.82   x10E9/L     1.8  -  6.8     N-A   ANC                      1500
250940 -    Neutrophils    Not Reported                                      Neutrophils       %        50  -  70
250942 -     ..
250943 -    LYMPHS                  2.04   x10E9/L     0.9  -  2.9     L-A   Lymphocytes       %        20  -  50
250944 -    MONOS                   0.38   x10E9/L     0.2  -  0.8     M-A   Monocyte          %         0  -  11
250945 -    EOS                     0.14   x10E9/L       0  -  0.4     E-A   Esoinophils       %         1  -  5
250946 -    BASOS                   0.09   x10E9/L       0  -  0.1     B-A   Basophil          %         0  -  2
250948 -     ..
250949 -    <----------------------- U C S F -----------------------> <-------------  Kaiser -------------->
250950 -    Type                 Results   Units        Normal        ACRO   Type            Units        Normal
250951 -    ELECTROLYTE PANEL                                          LYTE
250952 -    SODIUM             L  127      mmol/L      134  -  143     NA    Sodium            mEq/L   137  -  145
250953 -    POTASSIUM               3.8    mmol/L      3.4  -  4.9     K     Potassium         mEq/L   3.5  -  5.3
250954 -    CHLORIDE           L   95      mmol/L       98  -  107     CL
250955 -    CARBON DIOX TOTAL  L   22      mmol/L       23  -  32      CO2
250956 -  * ANION GAP                                    3  -  14      ANGA
250957 -     ..
250958 -    UREA NITROGEN          16      mg/dL         8  -  23      BUN   BUN               mg/dL     7  -  17
250959 -  * GLUCOSE               145      mg/dL        70  -  199     GLU   Glucose           mg/dL     ?  -   ?
250960 -    AST                    34      U/L          16  -  41      AST   AST (SGOT)        U/L      14  -  36
250961 -    ALT                    26      U/L          11  -  54      ALT   ALT (SGPT)        U/L      11  -  66
250962 -    BILIRUBIN, TOTAL        0.7    mg/dL       0.3  - 1.3      BILT  Bili Total        mg/dL   0.2  - 1.3
250963 -    ALKALINE PHOSPHATASE   90      U/L          29  - 111      ALKP  Alkaline Ph       U/L      38  - 126
250964 -     ..
250965 -  * PROTEIN, TOTAL                 g/dL        5.8  - 8.0      TP    Protine Total     g/dL    6.3  - 8.2
250966 -  * ALBUMIN            In Lab      g/dL        3.4  - 4.7      ALB   Albumin           g/dL    3.4  - 4.8
250967 -    CALCIUM         L       8.3    mg/dL       8.7  - 10.1     CA    Calcium           mg/dL   8.4  - 10.2
250968 -     ..
250969 -    MAGNESIUM               1.9    mg/dL       1.8  -  2.3     MG    Magnesium         mg/dL   1.6  -  2.3
250971 -     ..
250972 -    CREAT with eGFR
250973 -    CREATININE              0.46   mg/dL      0.42  - 1.06     CR    Creatinine        mg/dL   0.6  -  1.2
250974 -
250975 -      Note: Creatinine assay changed to IDMS standardization on
250976 -      February 4, 2008 causing decrease in results of approximately
250977 -      0.09 mg/dL
250979 -     ..
250980 -    eGFR if Caucasian     >60      mL/min                      GFRC
250981 -    eGFR if African Amer  >60      mL/min                      GFRA
250982 -
250983 -      eGFR corrected for 1.73 sq meters of body surface area
250984 -      Note:  eGFR is only an estimation. Please see online Lab Manual
250985 -      for potential limitations.
250986 -      Performed at Mt Zion Clin Lab, 1600 Divisadero, San Francisco,
250987 -      CA  94115
250989 -     ..
250990 - *  Labs today included following tests previously omitted...
250991 -
250992 -            GLUCOSE.............................. ref SDS 0 SE9J
250993 -            ALBUMIN
250995 -     ..
250996 -    Labs today show following omitted from test...
250997 -
250998 -            PROTEIN, TOTAL....................... ref SDS 0 GT9I
251000 -     ..
251001 -    Labs on 080821 included tests previously omitted...
251002 -
251003 -            GLUCOSE.............................. ref SDS H1 SE9J
251004 -            PROTEIN, TOTAL....................... ref SDS H1 GT9I
251005 -            ALBUMIN
251007 -     ..
251008 -    Labs on 080821 omitted following tests...
251009 -
251010 -            GLUCOSE.............................. ref SDS F6 SE9J
251011 -            ALBUMIN.............................. ref SDS F6 GT9I
251012 -            PROTEIN, TOTAL
251014 -     ..
251015 -    Labs on 080726 omitted following tests...
251016 -
251017 -            GLUCOSE.............................. ref SDS D8 SE9J
251018 -            ALBUMIN.............................. ref SDS D8 GT9I
251020 -     ..
251021 -    Labs on 080626 omitted following tests...
251022 -
251023 -            GLUCOSE.............................. ref SDS B7 HS7I
251024 -            PROTEIN, TOTAL
251025 -            ALBUMIN
251026 -            CALCIUM
251028 -  ..
251029 - Case study on 080626 shows these four tests, which have been omitted
251030 - and included in various combinations the past 4 cycles, where
251031 - consistently included for the prevous 15 cycles. ref SDS B7 HS8F
251032 -
251033 -
2511 -

SUBJECTS
Default Null Subject Account for Blank Record

2603 -
260401 -  ..
260402 - Cancer Marker CA 15-3 95 Decreases Over 4 Weeks from 96
260403 -
260404 - Follow up ref SDS H1 VK6H, ref SDS F6 VK6H.
260405 -
260406 - Diane submitted results of CA 15-3 95 for the blood test last starting
260407 - the 8th cycle. ref SDS H1 A16M
260409 -  ..
260410 - This is a welcome relief from the huge jump last month, reported in
260411 - the record a week ago on 080918. ref SDS H1 VK6H
260413 -  ..
260414 - Improved cancer marker, together with significant improvement in blood
260415 - counts, per below, ref SDS 0 PU6K, may signal increased exercise this
260416 - month, reported a few days ago on 080923, ref SDS H3 FN5K, is helping
260417 - to reverse or at least slow advance of cancer by enabling robust
260418 - treatment, as set out by the doctor on 030606. ref SDS 1 NE5G
260419 -
260420 -
260421 -
260422 -
2605 -

SUBJECTS
Absolute Neutrophils Count ANC 6850 Above 1500 NEUTS 6.85 Above 1.5

3503 -
350401 -  ..
350402 - NEUTS 3.82 Increase 2nd Week Chemotherapy Received
350403 - Chemotherapy Received Blood Counts Rise Significantly
350404 - Blood Counts Rise Significantly Chemotherapy Carboplatin Received
350405 -
350406 - Follow up ref SDS H1 PU6K, ref SDS G7 PU6K.
350407 -
350408 - Blood counts increased this week, shown by the Lab report today with
350409 - NEUTS 3.82, ref SDS 0 QY6H, compared with NEUTS 2.01 last week on
350410 - 080918, ref SDS H1 QY6H  This is well above UCSF standard of 1.5 for
350411 - Millie to safely get chemotherapy treatment.  Since today is the 2nd
350412 - week in the new cycle, Millie had 2 Neupogen treatments last week at
350413 - Kaiser, reported on 080920, ref SDS H2 UZ7K, and according to the
350414 - schedule on 080905. ref SDS G6 6E8N
350416 -  ..
350417 - Neutropenia has caused a "roller coaster" above and below specified
350418 - target from week to week, while getting Neupogen treatments in recent
350419 - months; today seems to show possible lessening of neutropenia with
350420 - blood counts rising several weeks in a row, shown in case study below.
350421 - ref SDS 0 OK67
350422 -
350423 -            [...below, consideration skipping Neupogen treatment if
350424 -            blood counts remain high. ref SDS 0 5U5F
350426 -  ..
350427 - Patient history getting cetuximab and Carboplatin is listed above.
350428 - ref SDS H1 5B6J
350430 -  ..
350431 - Side effects of Neupogen is listed below. ref SDS H1 SB8I
350433 -  ..
350434 - Fitness from hiking is listed in case study on 080915. ref SDS G8 KO6F
350435 -
350436 -
350437 -
350438 -
3505 -

SUBJECTS
Default Null Subject Account for Blank Record

3603 -
360401 -  ..
360402 - Neupogen Case Study Missed Carboplatin Treatments Low Blood Counts
360403 -
360404 - Follow up ref SDS H1 EP7N, ref SDS G7 8O7I.
360405 -
360406 - Case study on 060809 shows Millie has often received chemotherapy when
360407 - blood counts are below the standard for safe treatments, and on some
360408 - occassions has received Neupogen to increase blood counts. ref SDS 7
360409 - HV45
360411 -  ..
360412 - Research on neutropenia was reported on 070301, ref SDS 17 O59H, when
360413 - Doctor Rugo was concerned about holding blood counts with weekly
360414 - Carboplatin treatments. ref SDS 17 VF6O
360416 -  ..
360417 - Millie has received 32 Neupogen treatments, and missed 4 chemotherapy
360418 - treatments due to rising neutropenia.  Millie's letter to the medical
360419 - team on 080307 asked about solving low blood counts. ref SDS 83 HS6R
360420 - On 080423 Millie notified the medical team to maintain a full dose of
360421 - Carboplatin because these treatments yielded favorable response.
360422 - ref SDS 93 TY6Y  On 080501 a mixup in communication reduced the dose
360423 - of Carboplatin with the aim of not missing treatments.  Adding
360424 - Neupogen to avoid missing treatments might have enabled maintaining
360425 - full dose of Carboplatin to increase recovery. ref SDS 97 CZ3N
360427 -  ..
360428 - Discussion with the medical team on 080918 determined that if blood
360429 - counts improve significantly, then Neupogen treatment can be reduced
360430 - to save time and money, and to reduce side effects of Neupogen.
360431 - Today, with NEUTS 3.82, ref SDS 0 PU6K, if blood counts are at this
360432 - level or above next week, then Neupogen treatment might be skipped the
360433 - following week during the treatment when Millie does not get
360434 - Carboplatin.
360436 -  ..
360437 - Fitness from hiking is listed in case study on 080923. ref SDS H3 KO6F
360439 -  ..
360440 - Ability to maintain blood counts reported today, enables steady
360441 - chemotherapy treatments.  This may relate to stabilizing cancer marker
360442 - CA 15-3 95 on 080918. ref SDS H1 VK6H  Millie has received only 18 of
360443 - 22 total treatments prescribed with Carboplatin, since starting the
360444 - 2nd arm of the clinical study on 080306...
360446 -        ..
360447 -                      Neupogen            Carboplatin
360448 -       Date    NEUTS  Cur Totl Cycl Trm  Rcvd   Missed
360449 -
360450 -        080925  3.82   2   34    8   2    18.......... ref SDS 0 QY6H
360451 -        080918  2.07   2   32    8   1    17.......... ref SDS H1 QY6H
360452 -        080911  1.43   2   30    7   4    16.......... ref SDS G7 QY6H
360453 -        080904  1.99   2   28    7   3    16.......... ref SDS G5 QY6H
360454 -        080828  3.09   2   26    7   2    15.......... ref SDS G4 QY6H
360455 -        080821  0.99   2   24    7   1    14      4... ref SDS F6 QY6H
360456 -        080814  1.37   0   22    6   4    14.......... ref SDS F4 QY6H
360457 -        080807  2.41   2   22    6   3    14.......... ref SDS E8 QY6H
360458 -        080731  1.92   2   20    6   2    13.......... ref SDS E2 QY6H
360459 -        080724  2.32   2   18    6   1    12.......... ref SDS D8 QY6H
360460 -        080717  2.47   1   16    5   4    11.......... ref SDS D1 QY6H
360461 -        080710  5.12   2   15    5   3    11.......... ref SDS C5 QY6H
360462 -        080703  2.90   2   13    5   2    10.......... ref SDS C2 QY6H
360463 -        080626  1.80   2   11    5   1    09.......... ref SDS B7 QY6H
360464 -        080619  0.74   1    9    4   4    08.......... ref SDS B2 QY6H
360465 -        080612  3.77   2    8    4   3    08.......... ref SDS A9 QY6H
360466 -        080605  1.55   2    6    4   2    07.......... ref SDS A6 QY6H
360467 -        080529  2.26   1    4    4   1    06.......... ref SDS A5 QY6H
360468 -        080522  0.96   0         3   4    05.......... ref SDS A2 QY6H
360469 -        080515  1.21   0         3   3    05      3... ref SDS A1 QY6H
360470 -        080508  5.41   1    3    3   2    05.......... ref SDS A0 QY6H
360471 -        080501  1.34   1    2    3   1    04.......... ref SDS 98 QY6H
360472 -        080424  1.34   0         2   4    03.......... ref SDS 95 QY6H
360473 -         ..
360474 -        080417  0.95   0         2   3    03      2... ref SDS 92 QY6H
360475 -        080410  6.85   0         2   2    03.......... ref SDS 90 QY6H
360476 -        080403  1.34   1    1    2   1    02.......... ref SDS 87 QY6H
360477 -        080327  2.30   0         1   4    01.......... ref SDS 86 QY6H
360478 -        080320  1.28   0         1   3    01      1... ref SDS 85 QY6H
360479 -        080313  2.05   0         1   2    01.......... ref SDS 84 QY6H
360480 -        080306  1.75   0         1   1    00.......... ref SDS 82 QY6H
360481 -
360482 -
360483 -
3605 -

SUBJECTS
Default Null Subject Account for Blank Record

3703 -
370401 -  ..
370402 - Side Effects Neupogen Treatments Continue Mild Tolerance Acceptable
370403 -
370404 - Follow up ref SDS H1 SB8I, ref SDS G7 SB8I.
370405 -
370406 - Fitness from hiking is listed in case study on 080923. ref SDS H3 KO6F
370407 -
370408 -        [...above, see consideration to skip Neupogen treatment, if
370409 -        blood counts remain high next week. ref SDS 0 5U5F
370411 -  ..
370412 - Side effects of Neupogen may be lessening, reported on...
370413 -
370414 -               080923................, ref SDS H3 K16F
370415 -               080915................, ref SDS G8 9W9I
370416 -               080810................, ref SDS F2 9W9I
370417 -               080803................, ref SDS E3 9W9I
370418 -               080726................, ref SDS E0 9W9I
370419 -               080721................, ref SDS D5 9W9I
370420 -               080713................, ref SDS C8 RM94
370421 -               080629................, ref SDS C1 6Q5J
370422 -               080628................, ref SDS B9 6Q5J
370423 -
370424 - ...suggesting increased ability to tolerate 2 Neupogen treatments per
370425 - week.
370426 -
370427 -
370428 -
370429 -
370430 -
370431 -
370432 -
370433 -
3705 -