Blood level question

Hi Everyone-

It's been a while since I blogged. Luckily things have been going pretty well for my father, but I just got a call from his nurse today as we are prepping all his lab results to bring to his doctor appointment next week. He's been on coomadin for a month or so now due to a heart blockage in July in addition to his Revlamid treatment for Myeloma 15mg+ 20 mg dex. so they monitor his blood every week.

With that said he had a transfusion last week and went for blood today and the nurse said his labs from today were a little low. His wbc counts were low and a few other numbers. She said the doctor may need this when re-evaluating his dosage. His myeloma levels are around .85, but it sounds like the chemo may now be affecting some of his other blood counts negatively. Has anyone experienced this? If so, what usually happens from here? In the past they talked about lowering his dose, but then he had the heart attack and was off his chemo for a month and that went out the window.

One other question regarding Aerida, he went last week and they sent him home because his calcium was a little low. He does take a calcium tablet, but I guess it's not enough they are also re-evaluating this. Any experience this?

 Thanks in advance for any replies, they are always extremely helpful!

yes, it's very common for the drugs to move blood counts in both directions.  sounds like your doctor has some flexability in the revlmid dosage.  they'll usually watch/mark a trend before making an adjustment to the treatment plan

best of luck to you and your husband

doug

Hi Kpupfight~~

I agree with Doug in that drugs can affect all of your different blood levels and this happened to me with Revlimid.  I was started on 50mg, within 2 weeks reduced to 25mg and 2 weeks later down to 10mg which I have remained on for over three years.  Even this level of Rev makes me neutropenic by the end of each cycle, but my doctor has monitored it closely and knows that this happens but that I regain some sort of normalacy before starting the next cycle -- those 7 days make the difference.  Also, the combination of drugs Rev + Dex and/or heart meds, can  also change your readings and when your doctor reviews all of what is happening over a period of time he can easily tell whether you need to alter any of them.  Of course, as many people have said on this board, each of us is unique and our response to the various drugs is also unique so there is no 'one size fits all' when it comes to myeloma.  I have dropped down to Aridia 4 times per year instead of monthly, but there is a blood test before each dose just to insure that all of the levels are right before they administer anything that could make the situation even worse. It sounds as though your medical staff understand the workings of these drugs and are being very careful -- you really can't ask for better.  I'm sure that if you give them a ring and ask your questions they will be happy to explain.  Best wishes -- if the doctor does need to reduce the Rev he can take it down to 10 or even 5mg -- so there is still plenty of room to move.  As well, there are many other 'novel' drugs that could be used -- so it could be he may need something different.  Good luck to you both, Cath 

Good Morning Kpupfight;

But it sounds like the chemo may now be affecting some of his other blood counts negatively. Has anyone experienced this?

Yes, the chemo lowers all my counts.  

If so, what usually happens from here?

There are shots available to help stimulate the blood cells. One I get often is ARENESP.

Take care;

Kevin

Thanks everyone!

So many times over the past 1 1/2 year you have provided such insightful responses and have helped us along this journey. Much appreciated!