Hi,
Has anyone experienced high ALT counts while on Revlimid? Blood work should be between 0-55. My husband's jumped to over 1800 after only 18 days on Revlimid.
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phively - Name: jojo
- Who do you know with myeloma?: Husband
- When were you/they diagnosed?: Dec., 2011
- Age at diagnosis: 53
Re: Revlimid and high ALT - liver damage
Greetings from sunny (at least today) Seattle!
This is a very unusual – if it is actually from the drug. I did find a few mentions of this in the medical literature, but it is rare (see one reference below). Liver damage from Revlimid is manifested as elevated liver enzymes and hyperbilirubinemia and appears to be reversible within weeks after drug withdrawal / discontinuation.
Hopefully, your husband's liver function will return to normal with stoppage of the drug. Whether or not to restart it will be a touch decision for you and your oncologist.
Best of luck in your journey with this disease.
Reference:
MC Zanella et al, "A Case of Drug-Induced Hepatitis due to Lenalidomide," Case Reports in Gastroenterology, Jan-Apr 2011; 5(1): 217–222 (full text of article at PubMed) (full text PDF at publisher website)
Abstract:
Lenalidomide is a recent thalidomide analog used for the treatment of refractory multiple myeloma. The main toxicity of this drug consists in severe neutropenia and thrombocytopenia. Lenalidomide-associated liver injury is rare, manifesting itself as elevated liver enzymes and hyperbilirubinemia reversible upon weeks after drug withdrawal. We report here in detail the clinical course as well as the biological and histological alterations of an acute lenalidomide-induced liver injury. Findings on liver biopsy allowed us to discriminate acute inflammatory changes due to the drug and minor associated lesions of graft-versus-host disease in this patient with recurrent myeloma after allogeneic bone marrow transplantation.
This is a very unusual – if it is actually from the drug. I did find a few mentions of this in the medical literature, but it is rare (see one reference below). Liver damage from Revlimid is manifested as elevated liver enzymes and hyperbilirubinemia and appears to be reversible within weeks after drug withdrawal / discontinuation.
Hopefully, your husband's liver function will return to normal with stoppage of the drug. Whether or not to restart it will be a touch decision for you and your oncologist.
Best of luck in your journey with this disease.
Reference:
MC Zanella et al, "A Case of Drug-Induced Hepatitis due to Lenalidomide," Case Reports in Gastroenterology, Jan-Apr 2011; 5(1): 217–222 (full text of article at PubMed) (full text PDF at publisher website)
Abstract:
Lenalidomide is a recent thalidomide analog used for the treatment of refractory multiple myeloma. The main toxicity of this drug consists in severe neutropenia and thrombocytopenia. Lenalidomide-associated liver injury is rare, manifesting itself as elevated liver enzymes and hyperbilirubinemia reversible upon weeks after drug withdrawal. We report here in detail the clinical course as well as the biological and histological alterations of an acute lenalidomide-induced liver injury. Findings on liver biopsy allowed us to discriminate acute inflammatory changes due to the drug and minor associated lesions of graft-versus-host disease in this patient with recurrent myeloma after allogeneic bone marrow transplantation.
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Dr. Edward Libby - Name: Edward Libby, M.D.
Beacon Medical Advisor
Re: Revlimid and high ALT - liver damage
My liver enzymes were in 20's before Revlimid. Since, ALT is up to 40's. I am now off Revlimid, so will see if it goes down.
1800 sounds dangerous. Has your doctor suggested you stop treatment or look for other causes?
1800 sounds dangerous. Has your doctor suggested you stop treatment or look for other causes?
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Irish
Re: Revlimid and high ALT - liver damage
Before starting Revlimid, the ALT was 39. In just three weeks after starting 25 mg of Revlimid, it shot up to 1889. After 10 days off of everything, including aspirin, it was down to 452.
More bloodwork this week to see if it is down more and then hoping to start on 15 mg of Revlimid and watch the ALT numbers closely. The Revlimid was killing the cancer, but the side effects of liver damage are very scary.
More bloodwork this week to see if it is down more and then hoping to start on 15 mg of Revlimid and watch the ALT numbers closely. The Revlimid was killing the cancer, but the side effects of liver damage are very scary.
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phively - Name: jojo
- Who do you know with myeloma?: Husband
- When were you/they diagnosed?: Dec., 2011
- Age at diagnosis: 53
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