[Tony Y]

Tony's RVD induction therapy experience

by Tony Y on Wed Jun 07, 2017 4:06 pm

Time for my first update ...

I've done one Zometa treatment and one cycle of Revlimid, Velcade, and dexamethasone (RVD). Blood tests done before my second cycle show my M-protein (M-spike) is down from 3.2 to 1.2 g/dL (32 to 12 g/L). Seems like a nice improvement and the oncologist is very pleased.

My IgA is down from 60 to 30. Normal range is 70 - 400. Does anyone know the significance of this?

Platelet count is down from 240 to 164, but it is still in the normal range. Beta 2 and light chains have not been reported this time.

Side effects have been relatively minor from the RVD so far. The most interesting is that my blood pressure has dropped from 140/90 to 110/70. I'm thinking it is the daily aspirin they put me on to stop blood clots, along with the lisinopril they already had me on for high blood pressure. Anyway, the drop in blood pressure resulted in a dizzy spell every time I stood up, and a complete black-out one time when going from lying down to standing up. My regular doc took me off the lisinopril for now, with a check up in two weeks. Dizzy spells are now gone.

Other side effects include: Unsettled stomach, easily dealt with by prochlorperazine (Compa­zine). Puffiness around my eyes when taking the dex (4 days in 3 week cycle). Ringing in the ears. Slight numbness in the hands. Burning feeling in the hands and arms in the off-week, when not taking any drugs. Constipation, taken care of with Miralax (polyethylene glycol 3350).

Severe back pain was my only noticeable symptom of multiple myeloma when I was diagnosed in April 2017 and for that I was taking 4 Norco (acetaminophen / paracetamol & hyrdrocodone) per day, plus muscle relaxants, plus chiropractic care 3 times a week. Now, I have improved so much that the back pain is controlled by Tylenol and maybe 1/2 a Norco, no muscle relaxants, and chiropractor on an as-needed basis.

Overall, I'm feeling as good as I did 6 months ago, before the transition from MGUS to multiple myeloma.

That's about it for now. I'll keep you posted.

Tony

[kemscm]

Re: Tony's RVD induction therapy experience

by kemscm on Fri Jun 09, 2017 12:36 am

I'm just a bit behind you; I started Velcade, Revlimid, and dexa­metha­sone (VRD) yesterday. I'll be watching your posts. So far, so good here.

[Adam W]

Re: Tony's RVD induction therapy experience

by Adam W on Mon Jun 12, 2017 3:54 pm

I just started my second cycle with RVD on June 5, 2017. My first cycle was without Velcade.I've also had one Zometa treatment on May 23. I have a fracture at T10 causing a lot of back pain and rib pain on both sides. Taking morphine for pain. Other issues haven't been too bad: constipation, weight loss, and stomach pain. Some nausea and vomiting during first Velcade subcutaneous shot. The second shot was better. Overall, headed in the right direction.

- Adam

[Tony Y]

Re: Tony's RVD induction therapy experience

by Tony Y on Tue Jun 13, 2017 8:51 pm

So the dizzy spells are back. They occur after going from sitting / lying down to standing up. On reflection, they are more accurately described as light headedness. They went away during the week off of medications, but are back now that I am taking the Decadron (dexamethasone), 20 mg 4 times a week. Blood pressure seems to be about 15 points lower than the off week.

For reference, I'm on the standard leg of a clinical trial, taking Velcade, Revlimid, and dexamethasone, two weeks on, one week off per cycle.

Something I noticed by the end of the off week was the skin on my forehead and temples became scaly! I'm now entering the second week of my second cycle and the skin seems to be returning to somewhat normal.

The next thing to report is my second Zometa (zoledronic acid, 4 mg) treatment last Friday. Side effects were much reduced over the first infusion. First time, I could barely move in bed the next day due to muscle and joint pain, like a really bad case of the flu. This time, I felt a tiny bit fatigued, but otherwise functioned normally for the next two days. On the downside, improve­ments in back pain have not been as remarkable as from the first treatment.

After 1 1/2 cycles, my lambda free light chain level has dropped from 110 mg/L to 10.8, so now it's back in the recommended range for the first time since being diagnosed with MGUS 2 1/2 years ago.

Most of my CBC results are back in the normal range, apart from Lymphocytes Abs, which are 0.73 K/uL (ref. 1.1 - 4.0). I think I'll start a separate question about whether that is normal for RVD regimens.

Tony