[knstone]

Hi Neel,
Thalidomide dosage varies from doctor to doctor. Doctors at the Univ Ariz Cancer Center (an MDS center of excellence) did a lot of research with Thalidomide and Revlimid, they stated that dosages over 100 mg/day did not help the response but added to the neuropathy and dizziness. I've always tried to use the lowest dose that seemed to work. Early on my doctor had me try 150 mg/day but it seemed to cause too much dizziness. Over the 2.5 years I was on Thalidomide I used a dosage of 75mg/day average by taking 50 mg one day followed by 100 mg the next day.

You asked about my counts when starting Thalidomide. The counts seem to drop initially when one starts a new medication. Here were my counts:
Date Hgb WBC platelets
4/21/04 11 2.5 88 start day
4/28/04 11 1.8 64 drop in WBC, Platelets
5/05/04 11 1.5 69 took Procrit for next 7 wks
5/12/04 12 1.3 84 Started Neup for several wks
5/26/04 13 2.1 125
6/09/04 14 3.7 172
As can be seen I started to respond within 4 to 5 weeks.
My counts held very good until 04/2006 or 2 years, they then started a slow decline until we stopped the Thalidomide in Jan 07 and started Revlimid.
My doctor continued to give me Procrit and Neupogen occasionally.

Revlimid had a good response for approx 1.5 years at which time the WBC and Platelets were dropping, but the Hgb held very good. This is characteristic of Revlimid in some patients; helps Hgb but hurts WBC and Platelets.

Another problem with Thalidomide that I forgot to mention in another post to you is that it causes SEVERE CONSTIPATION, at least it did in my case. I had to take stool softners and laxitive pills. Senna-S at Walgreens and Miralax are good products in the US.

Hope this helps a little.