[adrian]

Revlimid and compromised kidneys

by adrian on Sat Feb 14, 2015 9:21 am

My brother's kidneys are quite compromised and the possible next treatment they are preparing for is Revlimid. Has anyone used this?

I see most people suggesting lose dose melphalan and prednisone. Was Revlimid available to you at that time?

[Cheryl G]

Re: Revlimid and compromised kidneys

by Cheryl G on Sat Feb 14, 2015 11:37 am

Hi Adrian,

If your brother's doctors give him Revlimid, they should make sure to adjust the dose to take into account his kidney impairment. There are dosing guidelines specifically for that situation.

See the prescribing information for Revlimid approved by the FDA here:

http://www.accessdata.fda.gov/drugsatfda_docs/label/2014/021880s039s040lbl.pdf

Section 2.4 on page 6 outlines the dose adjustments that should be made based on the patient's kidney function.

As I understand it, Velcade is generally the preferred treatment for myeloma patients with kidney failure. But I assume that option has been considered but decided against for some reason in your brother's case.

I've checked your previous postings and I'm not sure it's clear whether a myeloma specialist is involved in the decisions being made about your brother's care. If not, please do what you can to make sure that one is. Particularly in this kind of situation, whether the decisions are not simple, the experience of a specialists who sees these kinds of cases on a regular basis is extremely important.

Also, a myeloma specialist is not just a hematologist / oncologist. It's a hematologist / oncologist who has chosen to focus almost exclusively myeloma patients, and usually does research in that area as well.

Wish your brother all the best.

[Daisy]

Re: Revlimid and compromised kidneys

by Daisy on Sat Feb 14, 2015 8:35 pm

I have been on Revlimid maintenance (5 mg, 21 days on / 7 days off) for five years following an autologous stem cell transplant (ASCT) six years ago. My multiple myeloma was diagnosed when my kidneys failed. I was on dialysis for a short period of time. Currently, my GFR is stable at around 40 and creatinine moves between 1.09 and 1. 2. I have both a nephrologist and multiple myeloma oncologist on my team and am monitored every month with blood work and 24 hour urine collection. I remain in CR.

[adrian]

Re: Revlimid and compromised kidneys

by adrian on Sun Feb 15, 2015 7:33 am

Thanks Daisy. That is encouraging to hear. And thanks so much for answering.

[BillyL19]

Re: Revlimid and compromised kidneys

by BillyL19 on Sun Feb 15, 2015 6:48 pm

August 2011, I presented with kidney issues (creatinine in the double digits) when I was originally diagnosed with myeloma. I started on thalidomide, Velcade and dex for about 4 weeks until my kidneys got back on track (creatinine under 2). After that, I switched to Revlimid, Velcade and dex.

Don't know if that is an option, but I was under the impression thalidomide is processed in the liver and Revlimid in the kidney - thus a better option for me with the kidney issues.

Good luck.