Questions for Dr Seo

[pberggren1]

Well my doc told me yesterday that Cellcept is more similar to Imuran and does not target B cells.

[Daggar]

Cellcept disrupts production of both T cells and B cells - it also decreases activity of the entire immune system.

It's a possible option for Holly as she moves into the "maintenance" part of her treatment - that or Imuran.

[Daggar]

Lisa Marie -- did you ever have a biopsy? Invasive but that is the one test that really helps them nail down the diagnosis.

That's got to be very tough to not get that solid diagnosis.

[LisaMarie]

I had my first biopsies at Mayo in February...it showed chronic inflammation and inconclusive....so i go back on May on lower pred and more biopsies...I thought I had a solid diagnosis ...i trusted my WG specialist here and took all the treatment i can not tolerate cellcept or imuran...both increase my liver enzymes....i am hoping it is all those drugs and high doses of prednisone for so long is what makes me feel so bad and the RTX put the WG dog down for a long nap...i am on 20mg now and my joints ache worse and my voice keepa changing..but i will do what Dr Specks at Mayo says and deal...he needs me on 10mg to do further testing....He did not review all the records i sent over 300 pages so hopefully he will the next time i go...i don t think we have snow storms in May.I am going to print out a time line....so it is easier for me to explain to him what has happened....my Bronchoscopy from Mayo showed inflammation and narrowing of my bronchiles..right worse than left..so who know ....i will just have to trust Dr Specks

[LisaMarie]

cellcept and imuran are used also as anti-rejection drugs and work as Holly's father explain...but if u have no b cells it does everything else

[Sangye]

Well my doc told me yesterday that Cellcept is more similar to Imuran and does not target B cells.

Cellcept is similar to imuran in 2 ways: 1) Both are used to maintain remission, and 2) Neither is strong enough to induce remission unless you have very mild disease.

You must have misunderstood about the B cells, Phil. B cells are the "trouble-makers" in Wegs-- they produce the antibodies that attack our blood vessels. Cellcept specifically targets B cells. That's precisely how it helps us.

Cellcept is classified as an immunosuppresant because it targets B cells (fewer B cells means decreased ability to fight infection). With transplants, Cellcept keeps the body from making antibodies that will attack the organ.

Cellcept also targets T cells, but those aren't involved in Wegs.

Cellcept does not target all rapidly-dividing cells or DNA.

All traditional chemo drugs (ctx, imuran, mtx) are cytotoxic-- meaning they deliberately destroy rapidly-dividing cells. Blood cells (including B cells) reproduce quickly, so they are among those killed. All traditional chemo drugs affect cell division and/ or DNA. Chemo drugs are not targeted therapy like Cellcept.

I don't normally like to use images of warfare and violence when describing treatments, but right now the only analogy I can think of is that chemo is like a bomb and Cellcept is like a sniper.

Cellcept
- immunosuppressant
- not chemo
- "targeted therapy"
- targets B cells
- no effect on DNA or rapidly-dividing cells such as gut lining and hair
- "sniper"

Chemo (ctx, mtx, imuran)
- immunosuppressant
- chemo
- not targeted therapy
- affects all rapidly-dividing cells and DNA
- "bomb"

[pberggren1]

Thanks Sangye. I must have misunderstood my doc but will ask him again about it next time. I think I may be going on Imuran after ctx this time as a maintenance drug.

[Sangye]

Yeah, cellcept didn't seem to keep you in remission very well. I hope imuran will work well when you're ready for it.

[pberggren1]

Thanks Sangye. I hope so too. My gut feeling is that Imuran is the way to go.