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Old Tue Apr 20, 2010, 03:05 AM
King Farouk King Farouk is offline
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Join Date: Apr 2010
Location: Kuwait
Posts: 10
Quote:
Originally Posted by rose mcmillin View Post
Hi Hope that your Dad is improving. My husbands numbers dropped and his platelets are now just 25. Not sure what the new plan is, we will find out next Monday when we see the doc. We were off Vidaza for 6 weeks then the doctor decided to try it again and it tanked his numbers. Just waiting to see the next step.Any suggestions would be so appreciated. Thanks, Rose
Dear Rose,

Hope you are well. Most likely and hopefully your husband's marrow is only what they call being Myeloid suppressed due to the combination of disease and treatment. At this point the doctor will most likely suggest a Bone Marrow Biopsy a few days before the date of the new cycle and if I were you I'd insist on it, by doing that it solves part of the puzzle. If the results indicate a lower number of blasts than when you started during the diagnosis then Vidaza treatment is successful and although the transfusion independence may soon go and may not be reversible very soon, the doctor will most likely continue the Vidaza by reducing the dose or delaying the cycles or a combination of both. After trying that approach for 1 or 2 cycles (delay or reduction of dose) and if the counts do not recover they will suggest another Bone Marrow Biopsy to determine if the blast cells had increased from the 2 months or less prior. If no increase in Blast cells are present in the biopsy then they will most likely continue treatment with Vidaza. The persistent Cytopenia will be dealt with through RBC transfusions, platelet transfusions (perhaps direct family donors with group specific is ideal and lasts more) and Neupogen shots to increase white cell production. The Vidaza will continue to control the blast cells and the disease progression until further notice. I would not stop the vidaza unless there is a clear evidence that the marrow is no longer responding since once you are off of it, the next defense is Dacogen which has about 28% percent chance to work after Vidaza treatment according to a study and this is what my father had started last week. After that it is low dose Ara-c, cholorafarabine or Mylotarg and all of them have more serious adverse effects than Vidaza and Dacogen>

The above is a summary of our doctors opinion and hopefully it gives you sufficient discussion points to have with your husband's doctor.

Wish you the best and let us know what they say on Monday.

H
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Farouk, 78 yrs, MDS RAEB-II, complex cytogenetics, Dx Aug/09, treated with Vidaza Sep/09 until present
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