After good response to cyclophosphamide Velcade dex for 18 months, lambda multiple myeloma numbers started to rise. And so we have switched to Revlimid 25 mg daily plus dex 20 mg weekly.
After completing one cycle, the lambda number rose from 400 to 600. There is bone involvement at this level. We are curious to hear how long it takes for Revlimid to begin working. Is it possible that it will take 2 or 3 cycles before we see a decrease in the lambda number? Or should we consider that this treatment is a failure after one treatment cycle?
Thank you for sharing your knowledge and experience.
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silverberg - Who do you know with myeloma?: Care provider to my wife
- When were you/they diagnosed?: October 2011
Re: Revlimid dex responses
The treatment response is delayed by a couple weeks. Mine dropped from 300 after two cycles to 12 after four cycles.
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JBarnes - Name: Jerry Barnes
- Who do you know with myeloma?: Self
- When were you/they diagnosed?: Aug 17, 2012
- Age at diagnosis: 54
Re: Revlimid dex responses
The pace of response is different for each patient, and it's not unusual to take 2-3 cycles before a response is seen. So I wouldn't jump to conclusions after just 1 cycle. That being said, if the light chain numbers continue to climb significantly (for instance if they've gone up to 800 after the 2nd cycle), then this likely reflects primary resistance to the treatment and I would discuss with your oncologist about adding an additional drug or switching therapies.
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Dr. Adam Cohen - Name: Adam D. Cohen, M.D.
Beacon Medical Advisor
Re: Revlimid dex responses
Her lambda numbers went up to 2250 while on revlimide-dex and so she has Ben switched to melphaline-velcade-dex-thalidomide with the intention to follow up with a stem cell transplant.
After one cycle her lambda number has dropped to 685.
We are happy of course that she is responding with the change of treatment, but we are concerned that the thalidomide plus Velcade combo is causing her platelet numbers to crash to 50,000.
Does anyone have experience or thoughts on other possibilities such as ,melphaline- dex-velcade-doxyrubicine?
After one cycle her lambda number has dropped to 685.
We are happy of course that she is responding with the change of treatment, but we are concerned that the thalidomide plus Velcade combo is causing her platelet numbers to crash to 50,000.
Does anyone have experience or thoughts on other possibilities such as ,melphaline- dex-velcade-doxyrubicine?
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silverberg - Who do you know with myeloma?: Care provider to my wife
- When were you/they diagnosed?: October 2011
4 posts
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