[CureDO]

Treatment help - multiple myeloma & hemochromatosis

by CureDO on Fri Sep 20, 2013 9:43 pm

A relative of mine was just diagnosed with stage 3 multiple myeloma, but the situation is more complicated due to a 2nd diagnosis of Hemochromatosis. They have elevated ferritin, high blood pressure, but anemic also (from multiple myeloma)... seemed counter-intuitive until after some research to learn it this type of anemia is seen more commonly in chronic diseases. Calcium levels were very high, and renal function bad.

My question...

What is the best way to manage the iron/hemochromatosis while anemic?

A recent blood transfusion for the anemia made them feel even worse and Im not sure if this was the correct thing to do. Would eryhtropoeitin therapy be more appropriate or are the levels of erythro signaling already high and the problem is just the lack of room for the RBC to be created?

All the support sites indicate doing your own research is very important. I'm trying to better understand which direction is up and feeling more and more lost.

Thanks for any time or help anyone can provide.

[Dr. Jason Valent]

Re: Treatment help - multiple myeloma & hemochromatosis

by Dr. Jason Valent on Sun Sep 22, 2013 2:27 pm

I have used proton pump inhibitors to try and minimize iron absorption in hemochromatosis patients. Must monitor for B12 deficiency in this case as that can make anemia worse as well. Obviously cannot do phlebotomy. As the treatment starts and red cells are made at a better rate, some of the excess iron will be consumed. May be able to start the phlebotomy for the hemochromatosis once the myeloma is under better control.

all the best.