My dad was diagnosed with myeloma 1 month ago. He didn't appear to have any symptoms of myeloma when he was diagnosed and was started on chemo straight away.
Within a week, my dad was in hospital with an infection. He was sent home after 7 days recovering, but was rushed back into hospital 1 week later with kidney failure. He is now having dialysis and it looks like his kidneys are not going to work again.
What does this mean?
One doctor appears optimistic and then another says the prognosis is not good. He was fine 1 month ago and now he's half his body weight, on dialysis and can't seem to tolerate the chemo.
What is the prognosis with someone with myeloma and kidney failure?
My dad is also so unwell after the dialysis. He is hardly eating anything and my mum is petrified about having him home in case he gets an infection again.
He is on Velcade, steroids and cyclophosphamide.
Sad times.
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Re: Dad has myeloma, kidneys failing
Hi Luce,
So sorry to hear about your Dad.
I think the question most everyone on this forum would have is are you working with a multiple myeloma specialist on this, or just a general oncologist? I can't emphasize this point enough. Each situation with myeloma is very different and you need to be working with somebody that lives and breathes this disease on a daily basis. There are many different drug combos that can be utilized if one combo isn't working. There are also drugs that should be utilized or avoided if one has kidney impairment. If you let us know where you are located, we might be able to make some recommendations on specialists/facilities in your area.
So sorry to hear about your Dad.
I think the question most everyone on this forum would have is are you working with a multiple myeloma specialist on this, or just a general oncologist? I can't emphasize this point enough. Each situation with myeloma is very different and you need to be working with somebody that lives and breathes this disease on a daily basis. There are many different drug combos that can be utilized if one combo isn't working. There are also drugs that should be utilized or avoided if one has kidney impairment. If you let us know where you are located, we might be able to make some recommendations on specialists/facilities in your area.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Dad has myeloma, kidneys failing
I am sorry to hear about your father's situation. We are doing an ever better job in treating and taking care of our multiple myeloma cases everyday; however, complications of disease and related issues unfortunately can arise and compromise the best intentions.
I agree with the earlier post; myeloma is a rare disease that if possible you would like to get an opinion from a myeloma expert/referral center.
Depending on his initial therapy (Velcade Cytoxan and dex?), I would not suspect these to cause issues with your father's kidneys -- only to help. It was likely multi-factorial.
With what sounds like was treatment for less than a week and then being off therapy for a couple of weeks, disease may have contributed a significant portion (and likely caused an underlying damage to his kidneys regardless).
Further, the infection and potentially the antibiotics themselves, or combination of issues, may also have contributed. If he received any IV contrast dye with CT scans, or high doses of NSAIDs, these can also lead to renal failure in myeloma patients (remember: no IV CT contrast agent and no NSAIDs for myeloma patients).
With continued therapy (VCD) and some patience -- control of disease -- hopefully your father will regain levels of kidney function that will get him off HD. In the setting of renal failure and dialysis, Velcade Cytoxan and dex is excellent therapy.
I would also recommend that your dad be on prophylactic antivirals (acyclovir) and antibiotics (Cipro or similar) to protect him for infectious issues. He may also need additional supportive care with growth factors to keep him on therapy (e.g. Neupogen).
Even with a lot of optimism around our therapies and supportive care for myeloma these days, myeloma remains a serious malignancy.
Try to put your mom at ease: Home is the safest place from an infection stand point. Hospitals are good to get better, but not places that you want to stay for long periods of time.
Best of luck and wishes.
I agree with the earlier post; myeloma is a rare disease that if possible you would like to get an opinion from a myeloma expert/referral center.
Depending on his initial therapy (Velcade Cytoxan and dex?), I would not suspect these to cause issues with your father's kidneys -- only to help. It was likely multi-factorial.
With what sounds like was treatment for less than a week and then being off therapy for a couple of weeks, disease may have contributed a significant portion (and likely caused an underlying damage to his kidneys regardless).
Further, the infection and potentially the antibiotics themselves, or combination of issues, may also have contributed. If he received any IV contrast dye with CT scans, or high doses of NSAIDs, these can also lead to renal failure in myeloma patients (remember: no IV CT contrast agent and no NSAIDs for myeloma patients).
With continued therapy (VCD) and some patience -- control of disease -- hopefully your father will regain levels of kidney function that will get him off HD. In the setting of renal failure and dialysis, Velcade Cytoxan and dex is excellent therapy.
I would also recommend that your dad be on prophylactic antivirals (acyclovir) and antibiotics (Cipro or similar) to protect him for infectious issues. He may also need additional supportive care with growth factors to keep him on therapy (e.g. Neupogen).
Even with a lot of optimism around our therapies and supportive care for myeloma these days, myeloma remains a serious malignancy.
Try to put your mom at ease: Home is the safest place from an infection stand point. Hospitals are good to get better, but not places that you want to stay for long periods of time.
Best of luck and wishes.
-
Dr. Ken Shain - Name: Ken Shain, M.D., Ph.D.
Beacon Medical Advisor
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