Hi,
I am six months post auto SCT and had started on Revlimid 10mg as a maintenance regime. I completed 2 cycles of 3weeks on and one week off. As expected, by the end of the cycles, my white count, hgb, and platelets would drop. However, during the first cycle's break they rebounded quickly. After the second cycle, they did not rebound so I started taking the Revlimid every other day. Again, the counts dropped lower and the Revlimid was stopped completely. It has been a little over three weeks since the Revlimid was stopped. Now, my WBC's are 3.5, and my Hgb is 12.4. Those numbers recovered. My platelets, on the other hand, have not recovered. Over the course of the last 3 weeks (checked weekly) they were 42, 41, and 30. There has continued to be a drop. I am going to have them rechecked today and hopefully they are beginning to rise or I will need a platlet transfusion. My question is, can this still be a side effect of the Revlimid even though I have been off of it for 3 weeks? What else can cause this crash? I was on antibiotics (Augmentin) for a sinus infection during this time period. Could this have had an effect? My onc. is stumped.
Thanks,
Jodi
Forums
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Re: Low platelets
Many many things can cause low platelets. But, the most likely causes for you would be a combination of factors including:
1. Underlying bone marow dysfunction that you might have had prior to the diagnosis of myeloma (often unsuspected and not clinically evident)
2. Chemotherapy prior to the transplant
3. The chemotherapy administered for the transplant (Melphalan)
4. Revlimid
5. Drugs like antibiotics and many others
Revlimid could affect the marrow for up to 2-3 months. Ultimatley if this was due to the Revlimid the platelets should get better after it is stopped.
1. Underlying bone marow dysfunction that you might have had prior to the diagnosis of myeloma (often unsuspected and not clinically evident)
2. Chemotherapy prior to the transplant
3. The chemotherapy administered for the transplant (Melphalan)
4. Revlimid
5. Drugs like antibiotics and many others
Revlimid could affect the marrow for up to 2-3 months. Ultimatley if this was due to the Revlimid the platelets should get better after it is stopped.
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Dr. Edward Libby - Name: Edward Libby, M.D.
Beacon Medical Advisor
Re: Low platelets
Hello,
Dad had ASCT two months ago, and he's currently recovering. He is currently on antibiotics such as acyclovir and bactrim; but he is currently receiving zero myeloma meds.
He has never had low platelet counts. Three weeks ago, his platelets were 165,000. But today his counts were only 95,000. His hemoglobins also decreased from 11 to 9.5.
He's also had hep b and being prescribed entecavir 0.5 daily. He had cough for over two weeks, and he's currently on cefixime. He has been on cefixime before, and his platelets never dropped that low (other than very, very low during the autograft period).
Any comments are very enlightening. Thank you.
Dad had ASCT two months ago, and he's currently recovering. He is currently on antibiotics such as acyclovir and bactrim; but he is currently receiving zero myeloma meds.
He has never had low platelet counts. Three weeks ago, his platelets were 165,000. But today his counts were only 95,000. His hemoglobins also decreased from 11 to 9.5.
He's also had hep b and being prescribed entecavir 0.5 daily. He had cough for over two weeks, and he's currently on cefixime. He has been on cefixime before, and his platelets never dropped that low (other than very, very low during the autograft period).
Any comments are very enlightening. Thank you.
Re: Low platelets
Glad to hear that your father is recovering from his stem cell transplant.
Was your father ever treated with Revlimid or thalidomide? And, if he was, how long was he treated with the drugs?
Also, when was the last time he had a bone marrow biopsy? If it was recently, did the biopsy reveal anything suspicious in the marrow other than (perhaps) some myeloma cells?
Was your father ever treated with Revlimid or thalidomide? And, if he was, how long was he treated with the drugs?
Also, when was the last time he had a bone marrow biopsy? If it was recently, did the biopsy reveal anything suspicious in the marrow other than (perhaps) some myeloma cells?
Re: Low platelets
My platelets, and blood counts in general, dropped from diagnosis. They have recovered some, but my platelets are consistently -100. I'm 3 1/2 years from a SCT or any treatment.
I was given acyclovir and I believe it is a anti shingles virus drug and not an antibiotic.
I was given acyclovir and I believe it is a anti shingles virus drug and not an antibiotic.
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Wayne K - Name: Wayne
- Who do you know with myeloma?: Myself, my sister who passed in '95
- When were you/they diagnosed?: 03/09
- Age at diagnosis: 70
Re: Low platelets
Yes, he had about 12 cycles of VTD... I know it was a heck long of an induction therapy, but it was the time when we were battling whether to proceed with ASCT or not. However, he has never had Revlimid.
He has no fever. He passes stool and urine perfectly fine. So there's nothing to suspect with respect to internal bleeding.
What strange is that three weeks ago his counts were perfectly normal. HB has always been around 10, because he has thalassemia minor. What's scary is his platelets... Pre treatment it was hovering around 225,000. Post treatment around 170,000. And it was 165,000 threeweeks ago... Why all of a sudden it went down to 95,000 for no reasons? Should we check his hepatitis, maybe? He did stop his hep b meds for about a week due to severe nausea, but I doubt (crossing fingers) that it caused anything to his liver. Maybe it was again reactivated post ASCT and slowly building up? I dont know...
He has no fever. He passes stool and urine perfectly fine. So there's nothing to suspect with respect to internal bleeding.
What strange is that three weeks ago his counts were perfectly normal. HB has always been around 10, because he has thalassemia minor. What's scary is his platelets... Pre treatment it was hovering around 225,000. Post treatment around 170,000. And it was 165,000 threeweeks ago... Why all of a sudden it went down to 95,000 for no reasons? Should we check his hepatitis, maybe? He did stop his hep b meds for about a week due to severe nausea, but I doubt (crossing fingers) that it caused anything to his liver. Maybe it was again reactivated post ASCT and slowly building up? I dont know...
Re: Low platelets
Oh, he was very close to remission with respect to his BMB pre ASCT. I think less than 20% involvement and 21 kappa light chain, in his core, not aspirate. And he was now negative of p53del, whereas two years ago it was positive for p53del. (Docs confused with this genetics test.)
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