[Babs]

Should we reduce the Revlimid dose due to infections?

by Babs on Tue May 06, 2014 8:45 pm

Since September, my husband has been on 25 mg Revlimid (21 days/month) and 20 mg dexamethasone. His IgG levels are now normal, but he still has an M spike of 0.9. His neutrophils are in the low normal range.

In the last 4 months, he seems to be more susceptible to infections -- a cold sore virus that spread across his face, a lengthy cold, and now a pneumonia requiring 2 different antibiotics.

As he is on the highest Revlimid dose, I am wondering if reducing this might help his immune system while still continuing to lower the M spike? (He had an autologous stem cell transplant in 2010).

Thanks!

[Multibilly]

Re: Should we reduce the Revlimid dose due to infections?

by Multibilly on Thu May 08, 2014 8:41 pm

I think you know that low neutrophil levels make you more prone to infection. Either reducing the Rev dose and/or its timing would be something I would certainly be discussing with my doc.

http://www.cancer.org/treatment/treatmentsandsideeffects/guidetocancerdrugs/lenalidomide

"If you have any other medical conditions such as liver disease (including hepatitis), heart disease, diabetes, high blood pressure, gout, or INFECTIONS. These conditions may require that your medicine dose, regimen, or timing be changed"

Another option to discuss may be the use of a drug like Neupogen to boost one's neutrophils. I'm not a doc and I'm not qualified to say if reducing the Revlimid dose is preferred over adding a drug like Neupogen (or if Neupogen even makes sense in this situation).

In any case, it seems like your doc ought to be sensitive to the occurrence of these infections and taking some sort of action?

[antelope1225]

Re: Should we reduce the Revlimid dose due to infections?

by antelope1225 on Mon May 12, 2014 3:09 pm

My doctor dropped my Revlimid dosage because I was sick all the time. He said that Revlimid is to be given at "the highest dose tolerated" but if I was sick all the time, I wasn't tolerating it.

I put 2 posts in other places today about my incredible results from eating radical low carb for this last month. I am just one person, so this is obviously not a scientific study, but my improvement was amazing.