Well, our onc first mentioned Revlimid, but since my husband's acute kidney issue over the weekend, he has changed to dex and Cytoxan (cyclophosphamide). Both will be pill form.
I was just wondering if anyone knows if this will be it, or if a third agent might be added?
He is afraid the Revlimid will be too hard on his kidneys.
He was on high dose dex in the hospital, but what will the dose be for treatment? Also how often do you need labs, doctors' visits, etc, while on pill form chemo?
I assume on Cytoxan he will not be able to work and will need a leave.
Thanks
Forums
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dogmom - Who do you know with myeloma?: husband
- When were you/they diagnosed?: December 2015
- Age at diagnosis: 58
Re: Cytoxan instead of Revlimid
There are so many variables that go into deciding what dose of any medication to be prescribed. But, it is fairly common to start with 40 mg of dex once a week. The Cytoxan that your husband may be receiving won't limit him from working from what I've learned from reading experiences of others here. Revlimid can be hard on the kidneys so usually isn't prescribed when someone has recently had an acute kidney problem. He may also be prescribed one of the proteosome inhibitors such as Velcade (bortezomib), Kyrpolis (carfilzomib) or Ninlaro (ixazomib). The Velcade is usually a once a week injection, Kyprolis is usually a 2 times a week IV, and Ninlaro is the newly FDA approved pill.
I would bet that initially your husband will see the oncologist and have labs done at least once a week to follow his initial progress. There might be adjustments to his medications and doses as he responds to treatment.
Nancy in Phila
I would bet that initially your husband will see the oncologist and have labs done at least once a week to follow his initial progress. There might be adjustments to his medications and doses as he responds to treatment.
Nancy in Phila
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NStewart - Name: Nancy Stewart
- Who do you know with myeloma?: self
- When were you/they diagnosed?: 3/08
- Age at diagnosis: 60
Re: Cytoxan instead of Revlimid
When I was first diagnosed in Aug 2014, I was started on dex, lenalidomide (Revlimid) and bortezomib (Velcade). I relapsed after 4 months.
Then I took Revlimid, carfilzomib (Krypolis), and dex. After a few months, I started having chest pains and shortness of breath, and we discovered the carfilzomib was causing heart and lung damage, so that was stopped. The heart and lung damage has completely healed. Whew!
Now I'm on dex, pomalidomide (Pomalyst), and cyclophosphamide (Cytoxan). I've been on this combo for 6 months - I'm in my 7th cycle. So far, so good. I definitely think the side effects from this regimen are the best so far. I feel much better than I did on either Velcade/ Revlimid or Revlimid/ Krypolis. In fact, it was only with this regimen that I've even thought about trying to work part time. After the 8th cycle, I'll have complete re-staging (including PET CT, bone marrow biopsy and all the labs), and then we'll see if this combo is actually working.
Just my two cents.
Then I took Revlimid, carfilzomib (Krypolis), and dex. After a few months, I started having chest pains and shortness of breath, and we discovered the carfilzomib was causing heart and lung damage, so that was stopped. The heart and lung damage has completely healed. Whew!
Now I'm on dex, pomalidomide (Pomalyst), and cyclophosphamide (Cytoxan). I've been on this combo for 6 months - I'm in my 7th cycle. So far, so good. I definitely think the side effects from this regimen are the best so far. I feel much better than I did on either Velcade/ Revlimid or Revlimid/ Krypolis. In fact, it was only with this regimen that I've even thought about trying to work part time. After the 8th cycle, I'll have complete re-staging (including PET CT, bone marrow biopsy and all the labs), and then we'll see if this combo is actually working.
Just my two cents.
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Tracy J - Name: Tracy Jalbuena
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: 2014
- Age at diagnosis: 42
Re: Cytoxan instead of Revlimid
Thanks for the help guys. You are all so kind to help a new caregiver out. 
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dogmom - Who do you know with myeloma?: husband
- When were you/they diagnosed?: December 2015
- Age at diagnosis: 58
Re: Cytoxan instead of Revlimid
I know Cytoxan has been around for a while in the treatment of multiple myeloma. Is it as reliable in putting it in remission as the newer drugs?
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dogmom - Who do you know with myeloma?: husband
- When were you/they diagnosed?: December 2015
- Age at diagnosis: 58
Re: Cytoxan instead of Revlimid
Hi dogmom,
For those with acute kidney issues, bortezomib, Cytoxan and dexamethasone (40 mg has been the usual dose during induction) is a tried and true induction formula. I'd be asking the oncologist why Velcade (bortezomib) is not included. With any luck, the kidney function will improve – possibly even reverse itself – during the first few months of induction therapy.
One of the things I learned at support group meetings is each case is truly unique. Clinical trial results are a starting point, but one must look at who was included/excluded from the trial. Multiple myeloma patients with ongoing kidney impairment historically have been excluded. That is starting to change, particularly for clinical trials for relapsed or refractory patients.
Have you gotten the genetic findings back from your husband's bone marrow biopsy? Has the oncologist identified the 'risk' group for your husband's case?
Wishing you all the best for good results from the treatment protocol.
For those with acute kidney issues, bortezomib, Cytoxan and dexamethasone (40 mg has been the usual dose during induction) is a tried and true induction formula. I'd be asking the oncologist why Velcade (bortezomib) is not included. With any luck, the kidney function will improve – possibly even reverse itself – during the first few months of induction therapy.
One of the things I learned at support group meetings is each case is truly unique. Clinical trial results are a starting point, but one must look at who was included/excluded from the trial. Multiple myeloma patients with ongoing kidney impairment historically have been excluded. That is starting to change, particularly for clinical trials for relapsed or refractory patients.
Have you gotten the genetic findings back from your husband's bone marrow biopsy? Has the oncologist identified the 'risk' group for your husband's case?
Wishing you all the best for good results from the treatment protocol.
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philatour - Who do you know with myeloma?: spouse
Re: Cytoxan instead of Revlimid
Philatour,
No we learn the bone marrow biopsy results today. They were not back yet when he was discharged, as he was admitted the day it was done. I do hope the kidney issues will reverse themselves as he was very healthy prior to diagnosis. He may add the third drug today.
Thanks so much. I need all the help I can get.
No we learn the bone marrow biopsy results today. They were not back yet when he was discharged, as he was admitted the day it was done. I do hope the kidney issues will reverse themselves as he was very healthy prior to diagnosis. He may add the third drug today.
Thanks so much. I need all the help I can get.
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dogmom - Who do you know with myeloma?: husband
- When were you/they diagnosed?: December 2015
- Age at diagnosis: 58
Re: Cytoxan instead of Revlimid
They have added Velcade. So he is on CyborD.
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dogmom - Who do you know with myeloma?: husband
- When were you/they diagnosed?: December 2015
- Age at diagnosis: 58
Re: Cytoxan instead of Revlimid
Hi Dogmom,
CyBorD is the first line of treatment for multiple myeloma here in Canada (and Australia / New Zealand). From what I have heard from those who have had CyBorD, it has it's side effects, but generally no one reported being bedridden during this particular chemotherapy.
CyBorD is the first line of treatment for multiple myeloma here in Canada (and Australia / New Zealand). From what I have heard from those who have had CyBorD, it has it's side effects, but generally no one reported being bedridden during this particular chemotherapy.
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Little Monkey - Name: Little Monkey
- Who do you know with myeloma?: Father-stage 1 multiple myeloma
- When were you/they diagnosed?: March/April of 2015
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