Coley's Toxins IV #7 - A long but sub-optimal fever

Today's fever was uneventful but interesting. We went with an increased dose of 0.002ml thinking that an increase from 0.00075ml to 0.001ml wouldn't do much. We were right.

The chills began 1 hour after infusion start like clockwork. However, 3 hours after infusion start, her temperature was still 101.2F. It became apparent that today's was not going to a very high fever.

The fever stayed mostly between 101 and 102F for a good 3 hours. It briefly touched 102.5F but only for a few minutes.

In general, she was pretty fatigued for the duration of the fever. All other symptoms were consistent with previous fevers - bone pain in the hips, tingling in the fingers, very slight chills (with heating pad), one sided headache, elevated pulse. These were all minor and they all resolved quickly as the fever subsided. However, the fatigue seemed to linger a little longer than usual.

The lingering fatigue might be explained by her anemia. Her Hemoglobin, MCV and MCH were low even before we started on Coley's. The MBVax protocol explains that Coley's may cause anemia itself due to competition in the bone marrow for increased white cell production. Furthermore, it seems that fever itself can lead to a drop in iron levels. Well, today, we got the results of her CBC and Serum Iron test done last Saturday.

• Her iron levels are 33 ug/dL (normal being 50-180).
• Hemoglobin has improved a little to 10.8 (from 10.1)
• MCV declined slightly from 73 -> 72
• MCH declined slightly from 24 -> 23.9
• RDW is high at 18.7

It looks as like this is likely iron deficiency anemia. However, the Issels program does not recommend iron supplementation (iron through food is OK). Nevertheless, we have ordered Floradix iron supplements from the US via mail and hope that it'll make it to the hospital in a couple of days. Strictly speaking, we're not on the Issels treatment plan, but rather, we're following the MBVax protocol. And that protocol does call for Iron supplementation.

I also wonder if this anemia would compromise her body's capability to achieve higher fevers. Regardless, we will try to fix this and hope it'll resolve soon.

On a separate positive note, her total WBC is still at 7500/mm3 (if you remember, it doubled from 4000 to 8000 after the first 3 fevers. It has never been this high, ever, since chemo). In addition, a new development is her lymphocyte count is now at 2000/mm3. This is a first ever since chemo. Her highest has been around 1000/mm3 for the past 2 years since radiation and chemo.

Well, it looks like we'll have to increase dosage again the next time.