Hi tydt and cathybee,
Thalidomide is working in many ways - many of them probably still unknown. It is an immunomodulatory drug and inhibits the cytokines tumour necrosis factor-alpha, interleukins 1-beta, 6, 12, and granulocyte macrophage-colony stimulating factor. The drug stimulates primary human T, NKT and NK lymphocytes inducing their proliferation, cytokine production, and cytotoxic activity. It is anti-angiogenic (inhibits new blood vessels to the tumor cells), anti-proliferative, and pro-apoptotic (increases programmed cell death).
In some patients the drug decreases fibrosis - I have not yet had a BMB.
My ferritin was 5600 in July when I had got transfusions every week - now it is 1100
. When it is less than 1000 I will stop taking Exjade - 500 mg/day.
My WBCs have not increased. As you can see Thalidomide inhibits granulocyte macrophage-colony stimulating factor. Initially I took 50 mg/day but my WBCs decreased so I can only take 4 caps/week - that is 29 mg/day.
I still take Neupogen 2 injections/week (since neutropenic fever Sept 2007).
We don't know how long the drug will have effect but my HGB and platelets are still increasing very slowly.
Kind regards
Birgitta-A