My mother is on the Revlimid, Velcade, and dexamethasone (RVD) treatment regimen due to a high kappa-lambda ratio since January. She takes dexamethasone (40 mg) and Velcade on day 1 and then 10 mg Revlimid for 15 days. Her WBC drops with Revlimid, so the doctor gives her a 15 day break before she starts a new cycle. She already had 6 cycles so far.
My question is since the last 3 cycles her ANC is not recovering as it used to before. At the end of the first cycle it was 2033, 2698, 1670, 1690, 1333, 1625 and 1694 respectively.
Also, she did not have any Revlimid during 5th cycle due to low counts. But still her ANC at the end of 4th week only recovered to 1694 from 1625, while her overall WBC, hemoglobin and platelet count did increase a little.
My question is, is this concerning, or it might be due to side effects of Revlimid and Velcade. Her hemoglobin, platelets and WBC count keep on fluctuating with the latest values below,
Hemoglobin - 10.7
WBC - 3530 (4000-12000)
Platelets - 232000 (150000-400000)
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