Search: “Revlimid”

One more month to go

I have one more month to go of the high dose dex, which I’m now taking on a schedule of 7 days on and 7 days off. After the end of April, I’ll take what’s known as standard dose, which is 4 (40 mg each day) days at the start of the month or ten 4 mg tab once a week. For the past three years, I’ve taken it once a week, along with some other drug, or on its own, until it stopped being effective and I had to take more. I’ve never taken so much as I’ve had in the last three months though, and it’s wearing me out. I know I only have one more month to go, so I just have to hang in there. Dex causes me a lot of problems, as it does most people. I have stomach problems, thin skin, blurred vision, high blood sugar (on dex days), muscle weakness, PVCs, fatigue and about all the cushing’s symptoms you can get. I think the hardest thing about it is being so weak and shaky. If you’ve ever taken dexamethasone, you know what I’m talking about. You can’t even write because your hands shake so much.

When I see the doc on April 5th, I hope to find out if my insurance company has approved the harvest of my stem cells. If that’s the case, then I’d see when I can proceed with that. Since I’m in a trial, I’d have to drop out before I could have the Cytoxan (conditioning chemo), so I’d probably wait until Revlimid is approved by the FDA for the treatment of MM to do it. That way, I can stay on it for free as long as possible and then have it prescribed to me after the harvest if I need it. I’m so tired of feeling crummy that SCT almost looks good at this point.

Big Report

I have a lot to report tonight. First, my IgA has gone down more from the Revlimid/dex trial. Today’s result was 584 mg/dL. It’s never been that low since my diagnosis. You can see all the results I have back so far by clicking on “My Labs” above.

Once my MM is at an acceptable low level, we will harvest my stem cells. The way it works there at Wake Forest, is like this: They are going to contact my insurance company to make sure they will pay for a harvest and store. Once I have that approval, they will have me in the hospital for 2 days while they administer a fairly powerful dose of Cytoxan. Then they will start me on Neupogen for 10 days, which I will inject at home. I’ll have blood tests here at home to make sure my counts reflect the administration of the Neupogen. It’s supposed to mobilize the stem cells by producing so many that they spill out of the bone marrow into the blood stream. It can cause bone pain when it starts to crowd the marrow. It can be managed with pain meds, which I already have. I’ll return to WFUBMC and have my stem cells harvested through a process called pheresis, where the blood will be drawn out through an IV in one arm, the stem cells removed and the blood returned through an IV in the other arm.

I had an xray to look for lytic lesions. The doc said that AVN is painful when active and at rest, so he didn’t believe it was that. No lesion was found. That was good news. It’s probably the sciatic nerve or some inflammation somewhere.

I lost 4 more lbs between my last appointment 2 weeks ago and today. Seems weird, being on so much dex! But I’m glad. I’m not even trying. I think it’s probably the GI problems I have. Also when I’m on the dex, I don’t have much of an appetite. I’m very thirsty though. It’s when I’m off the dex that I have a ravenous appetite. I just don’t let myself have anything that’s bad for me. During dex days, I stay off carbs as much as I can & sugar (always off sugar, for that matter).

I am going to a different dex schedule. Since I’m so miserable on my days off (exhausted!), I am going to do a tapered dose that goes like this:

Day 1: 40 mg
Day 2: 40 mg
Day 3: 40 mg
Day 4: 24 mg
Day 5: 12 mg
Day 6: 6 mg
Day 7: 2 mg
Days 8-14 off
Day 15 – 21: same as days 1-7
Days 23-29 off

News

Diana Krall leads charity event for VGH & UBC Hospital Foundation … Canada NewsWire (press release) – Canada … L/BMT) Program of British Columbia is world-renowned for its care for people from across BC with cancers of the blood such as leukemia and multiple myeloma. …

Celgene’s Revlimid Has Upside Long-Term Potential < http://www.forbes.com/markets/economy/2006/03/08/celgene-revlimid-0308markets15.html> Forbes – USA… of key events lie on the horizon for Celgene (nasdaq: CELG – news – people ), including the pending approval of Revlimid for multiple myeloma, expected by the …

From the New York Times: A Cancer Drug Shows Promise, at a Price That Many Can’t Pay

More from KM:

From the New York Times: A Cancer Drug Shows Promise, at a Price That Many Can’t Pay

“Doctors are excited about the prospect of Avastin, a drug already widely used for colon cancer, as a crucial new treatment for breast and lung cancer, too. But doctors are cringing at the price the maker, Genentech, plans to charge for it: about $100,000 a year.”
For the complete story:
http://tinyurl.com/banwj

This is the same scenario for revlimid. Written off label for myloma, it costs three times as much as it does for MDS treatment since the dosage for MM is higher. And it makes the $100,000/year for avastin look like a bargain when Celgene charges $180,000/year for revlimid. This seems to be the trend for cancer drugs-price them so high that few can afford them or insurance can’t or won’t pay for them. In the meantime, people die.
Dave did get his first free revlimid today from the Expanded Access Program. We’ll get it free as long as we can so that we don’t burden our insurance company any more than we have to.

Rev/dex update

So far, the Rev/dex combo is working for me. It’s not without its problems though. My neuropathy has progressed considerably for the short time I’ve been on Revlimid. I started on January 11th, I think. It’s just a little over a month later, and my feet are more numb. I feel a little clumsy when I walk. My hands, which were only affected a small amount by thalidomide, are now burning. I have that same burning feeling on my face, around my nose and mouth. I will report these problems at my next appointment on the 22nd. If it seems to get worse in the meantime, I’ll call and tell someone.

I think most of the other problems I’m experiencing are due to the dexamethasone. I feel weak, shaky and tired. I developed the cushingoid symptoms with great speed. When you read about dex side effects, the ones that are supposed to be due to long term use seem to be standard for me. I get the classics: moon face, buffalo hump, turkey neck. You know what I’m talking about! I feel like a monster, and I bet I could scare little kids.

brrreeeport is the word of the day.

Starting second cycle

I started my second cycle of Rev/dex yesterday. So far, nothing bad! Just the dex sleeplessness and a bit of a headache. Normal dex stuff. Just 3 more months to go, and then I go to dex just 4 days a month and the Revlimid 21 days, like now. I had the quantitative Ig’s and SPEP done, as well as CBCs. The CBCs were all in the normal range. The RBC, HGB and HCT are all at the low end, but still in the normal range!

My Rev/dex update

I started the Rev/dex EAP trial on the 11th of January. I’m just about to
finish my first cycle. I’m on my 3rd dex pulse and have I think 3 more days
of Revlimid to take before I have a week off everything. On February 8th,
I’ll have my first SPEP and quantitative Ig tests done to see how I’m doing.
I have had one CBC done, just Wednesday, to check how my counts were being
affected by the drugs. My CBCs, as usual, were all in the normal range. I
have only had a very few times in the last 3 years when I was mildly anemic.
It appears that the Revlimid isn’t having any impact on my WBC or platelets
(or anything). I’m hoping that will remain the same.

On dex, I have high blood sugar. It stays under 200, so the doc doesn’t
want to treat. I have been increasing my exercise quite a bit so I can keep
that blood sugar down. Of course I watch my starch intake and avoid sugar
while on dex. On non-dex days, my blood sugar is normal.

The Revlimid has been ok so far. Just a few problems. The first 3-4 days I
had a pretty bad headache. It was enough to keep me in bed, under the
influence of Excedrin, Darvocet, Ultracet and Xanax. Sounds a bit over the
top, I know, but when I have a headache it can turn into a monster if I
don’t use all the drugs at my disposal. :) On days 3-6 I had diarrhea and
stomach pain. After that, things settled down mostly. Now I’m having
constipation, which is nothing I’ve ever had before! I have to say, it’s no
fun. I’ve been downing the fiber and today picked up some herbal tea that’s
supposed to get things going. When I was on thal, I never had that problem,
but was told to expect it. So, this is a surprise for me. I even put fruit
back into my diet, which I had been avoiding because of the sugar.
Typically, I have a lot of vegetables.

That’s it for me for now. I’ll be sure to post my Ig’s and m-spike when I
get them. Going into the trial, my IgA was 2445 mg/dL and my m-spike was
1.2 g/dL. When I was first diagnosed in Jan 2003, my IgA was 4625 mg/dL and
I had 2 m-spikes of 2.8 g/dL and 0.6 g/dL. I think the lowest my IgA has
been 781 mg/dL in September, 2003. That was when I was on thal/dex. I’m
hoping for as good or better results from Rev/dex. :)

Days on

Today is the last of my 4 days off from dex. In the morning I’ll start my 4 days on, with 40 mg. I’ve taken dex in the morning and dex in the night. It doesn’t seem to matter so much to me when I take it. It doesn’t seem to have the impact on my sleep that it used to have in the beginning. Of course, I’ve been off of it for 6 months until now, so it may be a cumulative thing. I’ll have to see. The first 4 days (last week) I didn’t have any bad indigestion or sleep problems, so all I can say is yay!

The stomach problems I was experiencing seem to have come to and end. Thank goodness for that, too. All I can think is that if the Revlimid was making me feel so crummy, it had to be making the cancer feel icky too.

I’ve been making myself walk more every day. Dex makes my legs feel really weak, so it’s my job to keep them strong. By spring I’ll be swimming too!