[newhope]

Rashes with Revlimid & thalidomide - best alternatives?

by newhope on Thu Apr 03, 2014 6:15 pm

My father was diagnosed with high risk smoldering myeloma last year at age of 68. His plasma cell was 40% and Kappa was 550. He started lenalidomide [Revlimid] (25mg/day) with dexamethasone since Dec. 2, 2013.

However he started to develop rash on his forearm and body trunk since Jan. 8, 2014. Then he was told to stop the medication and used a kind of cream called triamcinolone 0.1% ointment, and the rash disappeared after 1 week use of the cream. Although the dermatologist said my father can still continue to take lenalidomide as long as the rash is controlled by the cream. But his hematologist still insisted that my father should be off from the medication.

Since Feb. 3rd, he started thalidomide (200mg/day) with dexamethasone. Everything was fine until yesterday we found a little bit rash on his arm again. We are totally freaked out. It seems to me that he is reactive to thalidomide too.

He put the cream on his arm twice and it seems the rash was under control. However, he started to feel short of breath all the time. His hands start to shake when he holds stuff. His fingers start to feel numbness. When he walks, sometimes he feels that he is gonna fall as well.

I did some research and it seems that those are all the side effect of thalidomide. However his kappa has been stable for a while. His recent kappa number was 100 but his number one month ago was 90.

It worries us because it seems that thalidomide is not that effective although he is suffering from quite a lot of side effects.

My question is whether he should continue with thalidomide? If it is not effective, is there any other oral pill he can try?

I would really appreciate any of your input.

[Dr. Edward Libby]

Re: Rashes with Revlimid & thalidomide - best alternatives?

by Dr. Edward Libby on Thu Apr 03, 2014 10:06 pm

Hello,

Tremors and nerve problems (neuropathy) are common side effects of thalidomide.

I have to admit that I am truly worried about your posting. The shortness of breath is quite concerning and could signal many things, including a blood clot to the lungs (pulmonary embolism). Pulmonary emboli can be serious and even fatal. Thalidomide is well known to cause pulmonary emboli. I suggest that you discuss these symptoms with a health care provider immediately and/or go to an emergency room.