[wyatwe]

Initial results during Revlimid, Velcade, dex treatment

by wyatwe on Mon Nov 23, 2015 5:49 pm

How should I interpret these numbers and what should I focus on in my consultation with my hematologist tomorrow?

I did 14 days of treatment – Revlimid, Velcade, and dex – and have been off a week now.

Thanks

Test Oct 19 Oct 19 Nov 06 Nov 09 Nov 13 Nov 13
Hematocrit 35 34
(38 - 50 %)

Hemoglobin 11.7 11.4
(13.5 - 17.5 g/dL)

Neutrophils, Abs. 2.9 11.8

RBC 3.53 3.43
(4.32 - 5.72 M/uL)

WBC 4.9 11.7 13.9 15.5
(3.5 - 10.5 k/uL)

[lrankin]

Re: Initial results during Revlimid, Velcade, dex treatment

by lrankin on Mon Nov 23, 2015 6:35 pm

I think the most telling is the numbers that come from your monthly urine test. You want to look at the M-spike number and the light chain ratio.

I am fairly new to this so I hope others chime in.

[JPC]

Re: Initial results during Revlimid, Velcade, dex treatment

by JPC on Tue Nov 24, 2015 7:49 am

Hello, Irankin and Wy:

I agree with Irankin in that the primary markers for most patients would be the M-spike and the light chains (absolute and ratio). So Wy, those numbers you did not post, so I think that other Beacon readers would need to see those numbers to give you any type of informed commentary.

After one round of RVD, most patients do see a clear reduction in their M-spike. I would slightly disagree with Irankin in that the 24-hour urine test is routinely done, but it is a primary marker only in a specific, less common form of myeloma. However, Irankin, it was still a very good post for your first stab.

Good luck to you both.

[wyatwe]

Re: Initial results during Revlimid, Velcade, dex treatment

by wyatwe on Wed Nov 25, 2015 10:09 am

Would lymphocytes, monocytes, and granulocyte % be reflective of the markers mentioned?

[Multibilly]

Re: Initial results during Revlimid, Velcade, dex treatment

by Multibilly on Wed Nov 25, 2015 12:12 pm

Hi Wes,

I'm not a doc, so please check with yours.

I imagine you posted your CBC test numbers because your doc is likely routinely monitoring some of the markers in the CBC test to see if you are handling Revlimid & Velcade correctly. When on these drugs, some of the key things on the CBC that doctors watch out for are thrombocytopenia (low platelets) and neutropenia (low neutrophils). Your doc will know which specific platelet and neutrophil levels will be of a concern for the given drug cocktail you are currently taking.

However, the above CBC tests aren't really directly telling you how your treatment is impacting your monoclonal protein levels. For that, you should be looking at your M-spike on your serum protein electrophoresis (SPEP) and your free light chain numbers from your serum free light chain assay.

Now having said that, it does seem like you are still fairly anemic based on your hemoglobin numbers. If your normal lab range for hemoglobin is 13.4-17.5g/dL, then an Hgb value of 11.4 g/dL on 11/19 still technically qualifies you as being anemic (the "A" in the multiple myeloma "CRAB" criteria) by multiple myeloma standards. But it seems like you are still fairly early into your treatment, so it might be too early to expect a change in your hemoglobin numbers so soon? Again, your doc is the best person to comment on this.

[wyatwe]

Re: Initial results during Revlimid, Velcade, dex treatment

by wyatwe on Thu Nov 26, 2015 12:39 pm

Thanks. I'll be sure to get information on the M-spike on my serum protein electrophoresis (SPEP) and free light chain numbers from the serum free light chain assay.

My latest results posted have me with:

Platelet Count of 125, with normal being 140-415
WBC of 4.0, with normal being 4.0-10.5

[wyatwe]

Re: Initial results during Revlimid, Velcade, dex treatment

by wyatwe on Thu Dec 03, 2015 12:54 pm

My M-Spike was 0.4
My free Kappa Lt Chains were 19.98
My free Lambda Lt Chains were 8.66
Kappa/Lambda Ratio was 2.31