[pdw]

My 82 yr old mom has Multiple Myeloma just started chemo

by pdw on Fri Aug 13, 2010 11:33 pm

She just started tonight

Thalidomide

50 mg daily for 2 weeks
100 mg daily for 2 weeks
150 mg daily for 2 weeks
200 mg daily for 2 weeks

* I thought they said a break in between but, not on paper. He wants her at 200 mg but, slowly.

Dexamethasone 40 mg once a week

My mom has really thin bones and fell a month ago. She had a body scan last week. The dr told her leisons sp were but, not in major weight bearing areas. When she was diagnosed 6 yrs ago she did 2 yrs of aredia iv.

My question is why did dr choose these meds over others?

I was curious her being 82 how long can she do this treatment? I wouldn't think at her age she'd be on it the rest of her life?

I also wanted to know is how worried should I be of her falling on these drugs? At what point will she need a aide? Is it 2 weeks on 2 weeks off on the chemo.

Thanks

[Dr. Craig Hofmeister]

Re: My 82 yr old mom has Multiple Myeloma just started chemo

by Dr. Craig Hofmeister on Tue Sep 07, 2010 5:39 pm

Well the story here is not very long for someone that had myeloma diagnosed 6 yrs ago and just started thalidomide. I'll assume she was treated with Aredia for 2 years for her smoldering myeloma (this is unorthodox but may have a reasonable benefits:risks ratio) and now has symptomatic 'active' myeloma.

There is no data to state that she has to be on Revlimid instead of thalidomide and so any IMiD that she is responsive to is probably reasonable. Most physicians would only escalate up to 100 mg at bedtime of thalidomide because 200 mg is not likely to be sustainable. Yes you should be worried about falls because if she takes thalidomide and it deadens her sensation of her feet (which it will eventually, but this could take anywhere from weeks to years so she should not be afraid to SPEAK UP!), falls are inevitable.

I'm unclear how long she will be on thalidomide but you'll likely measure it in months, often 12-24 months in patients that have myeloma sensitive to thalidomide.

Make sure she's on 81-325 mg of aspirin (I prefer enteric coated) or some sort of more significant anticoagulation (e.g. full dose coumadin or low molecular weight heparin) as thalidomide/Revlimid can cause blood clots (e.g. DVTs & PEs)

[pdw]

Re: My 82 yr old mom has Multiple Myeloma just started chemo

by pdw on Tue Sep 14, 2010 4:18 pm

Thanks for reply I appreciate it. Yes my mom did aredia drip once a month for two years. They said, any longer it would cause side effects. She started it right away in 04. They said, it can help up to 10 yrs. She was considered stage 1 when she was diagnosed. My brother will ask doctor but, his goal is for her to hit 200 mg. Yes it is on two weeks off two weeks. I thought her being 82 they would not have her do this for the rest of her life but, not sure.


Does thalidomide really strengthen bones? or just slow down spread. She is on day 5 of week 1 of 100 mg. Sounds like you'd never put anyone on 200 mg of thalidomide. Is it too powerful side effects or too much leg weakness and numb feet. I'm concerned she will be bed ridden on 150 or 200 mg of thalidomide.


She has coughed alot is this a side effect of treatment

Thanks