Revlimid - Low White Blood Cells/Platelets - Experience?

Hi,

My mom is on revlimid. It has helped her immensely, Her Myeloma cells decreased about eighty percent; however, as a result, she has had extremely low platelets and white blood cells. Her doctor stopped the revlimid mid-cycle.

As a result of the low WBC count, she has had neupogen injections everyday for a week. This doesn't seem to be helping. In fact a couple of days ago the WBC count went down.

She has had platelet transfusions at least twice a week.

I'm wondering if anybody else experienced this on revlimid. If so, can you please tell me how your doctor handled it? Were you able to eventually resume the revlimid?

Thanks in advance.

 

On 2/27/2008 MotherWMyeloma wrote:

Hi,

My mom is on revlimid. It has helped her immensely, Her Myeloma cells decreased about eighty percent; however, as a result, she has had extremely low platelets and white blood cells. Her doctor stopped the revlimid mid-cycle.

As a result of the low WBC count, she has had neupogen injections everyday for a week. This doesn't seem to be helping. In fact a couple of days ago the WBC count went down.

She has had platelet transfusions at least twice a week.

I'm wondering if anybody else experienced this on revlimid. If so, can you please tell me how your doctor handled it? Were you able to eventually resume the revlimid?

Thanks in advance.

Good Evening MWM;

That's the nature of the chemotherapy, it can effect the good cells in our bodies also.

I had one occasion where I had to have a "boost" in my cell count and was put on ARANESP to bring my cell counts up into the normal range. It was delivered I.V. with my regular chemo and did the trick. However, my cell counts have always been in the low end of the range since being on Rev/Vel/Dex.

I also am on daily injections of NEUPOGEN. But this is for my upcoming Auto-SCT.

I know this hasn't helped you much but I was pretty fortunate while on the Rev/Vel/Dex combination and I wish you the best with your Mom.

Take care;

Kevin

 

Also the red counts are always slow to respond and they are usually 4 to 6 weeks behind treatment. Transfusions are usually given to bring these counts up until the marrow responds and takes over.Welcome to chemo. Velcade and Revlimid do have profound effects on Myeloma cells but unfortunately they are not "selective" Until the counts become problematic it is a tradeoff to kill Myeloma cells and give transfusions to counteract low counts.

Hi there MWM;

As others have said "That's the nature of the chemotherapy, it can effect the good cells too".

My dad was stage 3MM and on a Revlimid regime as part of a clinical trial.  He had several  occasions where he had to have a "boost" in his cell count and was put on ARANESP to bring his cell counts up into the normal range. He also had 2-3 transfusions per week.  Unfortuatnely the doctor  was not able to bring his white blood cell count and platelets into range.  Be very careful and monitor the situation.  Ask lots of questions.  My dad passed this last month, from the internal bleeding (not MM).

Everyone is different - my dad was diagnosed too late to help him.  I wish you the very best with your Mom.

Warmest regards,

 

Hi MwM --  I'm sorry that it has taken so long to respond to your message, but I'm working on the theory of better late than never!  To get down to the issue, I was started on Revlimid at 50mg x 21 days, 7 rest days.  I had weekly blood tests and very quickly we found the same problems that your mom is having.  My dosage was reduced to 25mg x 21 days, 7 days off and I was given fortnightly blood transfusions.  The regular blood tests continued and in a few weeks we discovered WBC drops again.  The dose was changed again - down to 10mg x 21 - and the transfusions continued every 10 days.  All this took about three months.  By this time my paraprotein was down lower than it had ever been since diagnosis.  I went from 90 to 8!  And here I am, 19months later and it is still 8.  I have not had any transfusions for over 15 months and although my counts currently make me neutropenic (which makes me very suseptable to any bugs going around) I have only succumbed to pnumonia once in all that time - I practice scrupulous hygiene and avoid all infectious situations!  So, in answer to your question, if your problem hasn't been solved, look at your mom's dosage and reduce the level of
Relimid. Have enough transfusions to rebuild her wonky blood levels - I use to call them my 'superman' infusions for I felt so much better after each of them.  In fact, I acted as a spokesperson for our local blood bank saying that all of the donors had given me 'time' for scientists to discover the drug which would help me to manage my condition!  People were very excited to actually see someone who benefited from their donations!  I'm off the track, sorry!    Regular blood tests will keep your mom's doctor on the pulse of her condition, and as you can see from Kevin's answer and others, there are things apart from transfusions which can help to stabalize her WBC.  My best wishes to you both - I hope you too can manage her condition with Revlimid as it appears to be working on reducing the paraprotein level so well, so don't give in!!  If I can help any way with personal experience, please don't hesitate to write.  You are both in my thoughts and prayers,  Cath