[Ellen Harris]

Elevated alkaline phosphatase (ALP) level

by Ellen Harris on Tue Dec 15, 2015 1:14 pm

Hi everyone,

Just wondering if anyone else on the forum has had elevated alkaline phosphatase (ALP) levels. Mine have been slowly rising over the course of the last few months, and my last reading was 135, which depending upon the lab, is on the outside of the high end of normal. I am waiting for the results of my last blood work, which I should have soon.

Background:

Diagnosed April 2014, induction with Revlimid, Velcade, and dex (RVD), stem cell transplant October 2015, complete response.

RVD maintenance (Velcade bi-weekly, 12 mg IV dex, 5 mg Revlimid, 21 day cycle) March 2015 - September 2015, off for two months due to some type of "virus" or muscle inflammation (CPK level 1500 - trip to ER for chest pain which was muscular).

Resumed maintenance of only Velcade and dex (bi-weekly) about 6 weeks ago.

Feeling OK, some GI problems, which surprised me. I thought it was the Revlimid! Wondering if the drugs are playing a role in the ALP reading. Also take Valtrex (valacyclovir), multivitamin, fish oils, vitamin D. Was on Zantac (ranitidine) for GERD for about a month or so, was able to discontinue that.

Oncologist says ALP nothing to worry about unless it gets to 170 ish. Not sure I want to wait for that!

Any advice, forum members? ALT and AST normal so far.

Thanks, Ellen Harris

[TerryH]

Re: Elevated alkaline phosphatase (ALP) level

by TerryH on Thu Dec 17, 2015 11:35 am

Hi Ellen,

You probably have seen this thread already, but just in case you haven't:

"Changes in ALP and ALT - what do they mean?" (forum disc. started Mar 5, 2015)

Dr. Libby posted in the thread and seems to agree with your oncologist, saying.

From what I've seen posted here in the forum, it does seem that treatment with Revlimid can lead to elevated liver markers. It doesn't happen often. In fact, you might say it only happens rarely. But there have been some cases reported here in the forum. See this list of forum discussions with "liver" in the topic, and you'll notice that many of them mention Revlimid (or RVD / VRD).

I wouldn't get overly concerned about the ALP level, but I'd keep an eye on your liver markers, just in case.

Good luck!