I was diagnosed with multiple myeloma in August 2009. Initially I had Revlimid 25 mg for 4 months and had my ASCT in early 2010. I have been in remission ever since. Six months after my ASCT my doctor put me on maintenance dosage. It was Revlimid 10 mg to begin with.
My free kappa number has been steadily going up after my ASCT. My doctor increased Revlimid dosage to 15 mg in early 2011. However, my free kappa number had been above the normal limit 1.94 mg/dL since June 2011. In May 2012 it went up to 2.62 mg/dL and I was concerned. At that time I had a bacteria infection, so my doctor prescribed me amoxicillin 500 mg 3 times a day for 10 days. To my surprise I found my free kappa number dropped to 1.60 mg/dL in the following June 2012 test. My Revlimid dosage was dropped to 5 mg after that, and my free kappa number stayed pretty much flat for the rest of 2012.
In January 2013 I had a tooth ache, and my dentist prescribed me amoxicillin 850 mg twice a day for 10 days. When I had my freelight chain test at the end of January, my free kappa number dropped to 1.28 mg/dL.
Eight months have passed and my free kappa number goes up again to 2.41 mg/dL. I am thinking about taking amoxicillin again. Does any one have similar experience with Revlimid + amoxicillin? I want to know if this is just a coincidence. Thank you.
Forums
9 posts
• Page 1 of 1
Re: Revlimid + amoxicillin, anyone?
Thank you EricW for sharing this interesting information.
There are other antibiotics that are used in myeloma treatments together with Revlimid; Biaxin and Doxil. Maybe amoxixillin is another candidate?
Åsa
There are other antibiotics that are used in myeloma treatments together with Revlimid; Biaxin and Doxil. Maybe amoxixillin is another candidate?
Åsa
-
asaryden - Name: asaryden
- Who do you know with myeloma?: myself
- When were you/they diagnosed?: August 2010
- Age at diagnosis: 48
Re: Revlimid + amoxicillin, anyone?
Just assumption why amoxicillin reduced FLC level when you had bacterial infection: Bacterial infection cause inflammation and release pro-inflaming cytokines that cause to b-cells to react by grows and/or by increasing b-cells metabolism. Amoxicillin eradicated bacteria and so stop inflammation. After that amount inflammation cytokines reduced and b-cells including malignant decreased they metabolism.
Have a nice weekend.
Igor.
Have a nice weekend.
Igor.
Re: Revlimid + amoxicillin, anyone?
I initially wondered if maybe amoxicillin was having the same effect as clarithromycin (Biaxin) when it's used together in combinations like "BirRD" (Biaxin+Revlimid+dexamethasone) and "ClaPD" (clarithromycin+pomalidomide+dexamethasone).
However, amoxicillin is from a different class of antibiotics than Biaxin. So that makes me less certain that it could be having the same effect as Biaxin does, which supposedly strengthens the effect of the dexamethasone when it is used in myeloma combination treatments.
So then I started to wonder something similar to what AM_AS expressed, which is whether what you are seeing is not the effect of the amoxicillin, but rather the effect of your infection coming and then going away.
I do wonder if that's what's going on.
Have you discussed what you've observed with your myeloma doctor? They would have a better idea if it's the amoxicillin, or the infection, that is causing your FLC numbers to change.
Have you observed any change in your m-spike during and after treatment with the amoxicillin?
However, amoxicillin is from a different class of antibiotics than Biaxin. So that makes me less certain that it could be having the same effect as Biaxin does, which supposedly strengthens the effect of the dexamethasone when it is used in myeloma combination treatments.
So then I started to wonder something similar to what AM_AS expressed, which is whether what you are seeing is not the effect of the amoxicillin, but rather the effect of your infection coming and then going away.
I do wonder if that's what's going on.
Have you discussed what you've observed with your myeloma doctor? They would have a better idea if it's the amoxicillin, or the infection, that is causing your FLC numbers to change.
Have you observed any change in your m-spike during and after treatment with the amoxicillin?
-
JimNY
Re: Revlimid + amoxicillin, anyone?
Thanks to asaryden, AM_AS, and JimNY. I appreciate your responses very much.
All other tests I have since my ASCT are normal. I did not have any M-spikes before and after I took amoxicillin. The only observation I had was FLC kappa out of its normal range before taking amoxicillin and normal FLC kappa after taking it.
As I mentioned before, my FLC kappa was above 1.94 mg/dL from June 2011 to May 2012. I did not have bacteria infection until June 2012. After taking amoxicillin 500 mg 3 times a day for 10 days, my FLC kappa dropped from 2.62 to 1.6 mg/dL in June 2012. I agree with AM_AS and JimNY that the number 2.62 mg/dL includes my normal immune response to the infection, but the FLC kappa number was already out of normal range before that.
Wikipedia says that amoxicillin inhibits the forming of cell walls for rapid growing cells. I hope it has similar effects on myeloma cells. Indeed, a side effect I observe is that taking amoxicillin would drop my WBC further, compared with taking only Revlimid. Luckily I am taking Revlimid 5 mg, so the side effect is tolerable, or I might need Neulasta shots after taking amoxicillin.
I plan to discuss this with my doctor for my next appointment in October. By then I will be able to see my FLC kappa number after this round of amoxicillin. I will keep you posted. Thanks again.
All other tests I have since my ASCT are normal. I did not have any M-spikes before and after I took amoxicillin. The only observation I had was FLC kappa out of its normal range before taking amoxicillin and normal FLC kappa after taking it.
As I mentioned before, my FLC kappa was above 1.94 mg/dL from June 2011 to May 2012. I did not have bacteria infection until June 2012. After taking amoxicillin 500 mg 3 times a day for 10 days, my FLC kappa dropped from 2.62 to 1.6 mg/dL in June 2012. I agree with AM_AS and JimNY that the number 2.62 mg/dL includes my normal immune response to the infection, but the FLC kappa number was already out of normal range before that.
Wikipedia says that amoxicillin inhibits the forming of cell walls for rapid growing cells. I hope it has similar effects on myeloma cells. Indeed, a side effect I observe is that taking amoxicillin would drop my WBC further, compared with taking only Revlimid. Luckily I am taking Revlimid 5 mg, so the side effect is tolerable, or I might need Neulasta shots after taking amoxicillin.
I plan to discuss this with my doctor for my next appointment in October. By then I will be able to see my FLC kappa number after this round of amoxicillin. I will keep you posted. Thanks again.
Re: Revlimid + amoxicillin, anyone?
I had amoxicillin 500 mg three times a day for 10 days, from September 13 to 23. My FLC kappa was 2.41 mg/dl on August 28.
I went to see my doctor yesterday (October 23) and had FLC test. Today the FLC Kappa number becomes available and my kappa number is 1.96 mg/dl.
Previously I had FLC tests done almost right after finished taking amoxicillin. This time the test was done one month after taking amoxicillin. Nevertheless the FLC kappa number did drop.
Is it coincidence three times in a row?
I went to see my doctor yesterday (October 23) and had FLC test. Today the FLC Kappa number becomes available and my kappa number is 1.96 mg/dl.
Previously I had FLC tests done almost right after finished taking amoxicillin. This time the test was done one month after taking amoxicillin. Nevertheless the FLC kappa number did drop.
Is it coincidence three times in a row?
Re: Revlimid + amoxicillin, anyone?
Thanks for the update, Eric.
Could you also give us the FLC lambda values for all the tests that you've mentioned, both the tests before and after the times you've taken amoxicillin?
It would be interesting to know what has been going on with the lambda values while your kappa values have been moving around.
Could you also give us the FLC lambda values for all the tests that you've mentioned, both the tests before and after the times you've taken amoxicillin?
It would be interesting to know what has been going on with the lambda values while your kappa values have been moving around.
-
JimNY
Re: Revlimid + amoxicillin, anyone?
Did you also see changes in your CBC results such as RBC, WBC, platlets and Ig?
-
Pjorg45 - Name: Paul Jorgensen
- When were you/they diagnosed?: May 1013
- Age at diagnosis: 68
Re: Revlimid + amoxicillin, anyone?
Hi, JimNY, my 3 amoxicillin experience is shown below. The first row shows my FLC numbers before taking amoxicillin and the second row shows my FLC numbers after taking amoxicillin.
Date Kappa Lambda Ratio
---------------------------------
2012-05-10 2.62 1.48 1.77
2012-06-06 1.60 1.11 1.44
---------------------------------
2012-10-30 1.41 1.00 1.41
2013-01-30 1.28 1.12 1.14
---------------------------------
2013-08-28 2.41 1.33 1.81
2013-10-23 1.96 1.48 1.32
Paul, as I mentioned before, the addition of amoxicillin drops my WBC further. Luckily I am taking Revlimid 5 mg, so the drop was tolerable for me. I had CBC tests on 09/12/2013 and 10/02/2013, and the results are shown below. Units are K/mcL.
Item 2013-09-12 2013-10-02
-------------------------------
ANC 1.1 1.0
WBC 2.2 2.3
RBC 4.36 4.40
Once my ANC dops below 1.0, I may need to take a Neulasta shot to boost my WBC.
My doctor told me that the mean time for patients on Revlimid maintenance therapy after ASCT is 42 months. I am currently 44 months.
My hypothesis is this: Taking amoxicillin (say when the FLC number reaches 2.5+mg/dL) may significantly increase the time beyond 42 months. Hope that patients in Revlimid maintenance therapy can all benefit from my experience here.
Date Kappa Lambda Ratio
---------------------------------
2012-05-10 2.62 1.48 1.77
2012-06-06 1.60 1.11 1.44
---------------------------------
2012-10-30 1.41 1.00 1.41
2013-01-30 1.28 1.12 1.14
---------------------------------
2013-08-28 2.41 1.33 1.81
2013-10-23 1.96 1.48 1.32
Paul, as I mentioned before, the addition of amoxicillin drops my WBC further. Luckily I am taking Revlimid 5 mg, so the drop was tolerable for me. I had CBC tests on 09/12/2013 and 10/02/2013, and the results are shown below. Units are K/mcL.
Item 2013-09-12 2013-10-02
-------------------------------
ANC 1.1 1.0
WBC 2.2 2.3
RBC 4.36 4.40
Once my ANC dops below 1.0, I may need to take a Neulasta shot to boost my WBC.
My doctor told me that the mean time for patients on Revlimid maintenance therapy after ASCT is 42 months. I am currently 44 months.
My hypothesis is this: Taking amoxicillin (say when the FLC number reaches 2.5+mg/dL) may significantly increase the time beyond 42 months. Hope that patients in Revlimid maintenance therapy can all benefit from my experience here.
9 posts
• Page 1 of 1
Return to Treatments & Side Effects