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Alert Number 30

Adding Neupogen to Rituxan Therapy

Date: July 6, 2004

Several readers have written about difficulties they are having in convincing their local oncologists to add Neupogen (G-CSF, granulocyte colony stimulating factor) to Rituxan therapy. Here is some ammunition that I think might help you make your case. Frankly, the evidence is now mounting up to the level where it is just about irrefutable.

A critical part of this process is, of course, a motivated patient who is willing and able to initiate this dialogue with his or her doctor. You get pretty much what you are able to negotiate, in life as in healthcare. Busy doctors take the path of least resistance, most of the time. Confront them with a well thought-out game plan, reasonable expectations of the outcome and well documented reasons why Neupogen should be added to your next round of Rituxan therapy, and you may very well get what your are asking for.

CLL Topics can help you with the documentation and logic. Write to us if you want to locate the full text articles of the abstracts I cite. But you will have to do the heavy lifting when it comes to the actual negotiation. Remember, communication is a two way street: you are responsible for getting across the point to your doctor, just as he is responsible for responding to your queries.

No question, there will be the few doctors out there who are intimidated and put-off by patients taking an active role in their own healthcare, bothering to learn. The best thing we can do with such physicians is to leave them strictly alone. Vote with your feet, find yourself a doctor who is willing to work with you. It is your life, your body, your CLL.

You can read about Rituxan + Neupogen on our website in an article titled Neupogen as Booster to Rituxan Monotherapy. With an EGCG chaser to guard against angiogenesis, that combination becomes "Harvey's" RHK protocol!

Be well,

Chaya
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