R-B VS R-CHOP

Hi  and welcome to the Online Community, although I am sorry to see you finding us and so sorry to hear that your husband has been diagnosed with FL.

I am Mike Thehighlander and help out arround our blood cancer groups. I had a different type of NHL Cutaneous T Cell Lymphoma (Skin Lymphoma) (CTCL) so had a different journey but there are a good number of folks who have had these two treatment R-CHOP or R&B Rituxan & Bendamustine so lets see who picks up on your post and see if they can help you out.

Over my years I have always went with my team as they should know what the best treatment is for each presentation

When you feel up to it try putting some information in your profile. This really helps others when answering. It also means that you don't have to keep repeating yourself. Just click on YOUR username, select 'Edit Profile'. Put as much or as little in your profile and you can amend it at any time - you can see members profiles by hitting our forum names....... like Thehighlander

((hugs))

Hi and welcome to the site, the is a lot to take in at this stage and being asked to choose a treatment when you know little about them makes it harder as like us when we were diagnosed you just want to get it right. Here is a link to a paper on the pro's and con's of each and is specific to grade 3a, this is the summary but of you click on the link on the page you can read it all.

https://www.ncbi.nlm.nih.gov/pubmed/29317554

The is a lot of research been undertaken on which may be the preferred first line treatment but that really does depend on the patient and their presentation.

RCHOP was the stronger treatment given some years back but R&B did become the newer treatment and some research indicates a longer disease free period. Did the consultant explain the differences between the two? if not worth following up with some questions once you have a better understanding and hopefully some of the FNHL folk will share their experiences. I had 8 rounds of RCHOP 10 years ago for DLBC which is an aggressive type of lymphoma, so different to that which your husband has.

Ask any questions and have a look at the information on the lymphoma action website, you can also call them and talk through your options, as you can here by asking on of the nurses, or calling to talk to them about the choice.

John 

Hi Mantis

I too had 3a NHFL. diagnosed in the summer of 2017.  I had to start treatment right away as an abdominal tumour was compromising my organs.

I was not given the option of R&B so can't comment on it.  I had 6 rounds of R-CHOP every 3 weeks.  A CT scan after 3 rounds showed a  'remarkable' reduction, and a post treatment PET scan showed complete remission.  I then had 15 daily sessions of Radiotherapy to mop up any residue followed by 2 years of Rituximab immunotherapy to make sure it stays away- 1 every 8 weeks, 12 in total.  I have my 11th next week.

the RCHOP was tolerable, not as toxic as I imagined. I did have side effects.....complete loss of all body hair (it grew back), cracked hands and feet to name a couple.  Days 10 to 14 each cycle were the worst, feeling very tired and sorry for myself and not fancying eating much apart from ice cream and boiled eggs, but most of the time I was generally not too bad.  Those 4 days each cycle, although not feeling great meant the treatment was working, so I embraced it. My blood counts were low during the chemo, so had to look after myself regarding infections.  I had to have a 3 day stay in hospital with an infection which they treated with antobotics and I was fine.

After cycle 4 of R-CHOP I started to develop peripheral neuropathy in my fingers and toes.  My doc therefore replaced the Vincristine (Oncovine, the O in RCHOP) chemical with Vinblastine so I wouldn't suffer permanent loss of feeling in fingers and toes, which worked.

Today I am healthy and fit and living life normally.

Best of luck with whichever treatment your husband chooses.

Tina

Hey,

I had OB which is a newer version of RB so it could be worth exploring this.

OB is obinutuzumab instead of rituximab but both OB and RB have bendamustine as the chemo part.

i tolerated OB extremely well during my regular 6 cycles of chemo/antibody treatment and cannot really fault that. I generally remained healthy and well through and it achieved a complete response remission in March.

since then I have had issues with the Obinutuzumab maintenance treatment which now seems to have put my bloods out of kilter and as a result I will have no further maintenance (I had 3 of the planned 12).

from what I have heard RCHOP is harsher and as I understand it that would be my current next treatment should my lymphoma return in the near future.

I wish you all the best , keep us informed as to how it all goes.

regards

Hello Mantis,

Sorry to hear about your husband's diagnosis.  John's link to the research news is highly relevant when one has to decide on treatments.  I read masses of the research studies last Autumn while I was waiting (6 months!) for my diagnosis of stage 4 follicular lymphoma.  I started treatment with rituximab and bendamustine in March and got my good news about being free of disease in July this year.  Mine was going to be RCV-B, a bit like RCHOP, but I too had a choice and went for the newer R-B  treatments on the basis of the research outcomes I read.

I gather O-B is even better, using obinutuzumab instead of rituximab, but from experience I can say that the R-B treatments were no big deal.  I had hands like pincushions at the end, but apart from the usual tiredness and an ache in my hip bone where the disease was being attacked by the chemo, I was pretty free of side effects in spite of being allergic to rituximab.  I have all my hair, my hands are normal again and I'm so glad I chose the R-B treatment!

Yes, one is certainly more prone to infections.  Bendamustine is very persistant and your immunity is sometimes very low without your realising it.   I've had a nasty dose of shingles, with added chickenpox, which was No Fun, but cleared up once I got treatment with antivirals.  Now I take low dose antibiotics and antivirals till the risk is passed, after about 9 months.  I feel healthy and remain disease free.  There's advice online on taking care when you've got poor immunity.  Most of it is pretty obvious - don't smoke, wash your hands, keep kitchens & food handling clean, get flu vaccines and any others you need and stay away from crowds of sneezing people.  Very low immunity is rare unless you have a stem cell transplant, but if you feel ill after chemo you should see a doctor ASAP, even if it feels trivial.  Most treatment teams have an informal advice line for patients who are worried anyway and act fast if you develop signs of infection.

So, maybe it's time to read the information and choose.  Whichever it is, I hope it goes as smoothly and comfortably as mine did.  Your team sound very confident and flexible, which is wonderful.  They're your new best friends!

All good wishes,

Cecren