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Thalidomide
Hi Neel,
Too bad that your father is so weak! Many patients that can't tolerate Thalidomide 100mg/day get lower doses with good or better effect. I am taking 29mg/day (4 caps รก 50mg/week) since July 2010 with positive effect - my WBCs decreased when I took 50mg/day.
As I have suggested before I think a low dose of Prednisone could increase your father's counts - especially the platelets. You know the platelets can fluctuate much. If they decrease from 30000 to 18000 they can increase next time. Do avoid everything that can decrease platelets like all types of pain killers.
I don't know if the lower counts depend on discontinuation of Thalidomide. The median response (50% of the responses) is 9 months so 4 months is a short response. There are a few patients who have responded several years - one study mentioned 6 years.
It is true that some patients respond several months after Thalidomide is stopped but I think it is better to cotinue with a lower dose.
Birgitta-A
72 yo, dx MDS Interm-1 2006, received 142 units of PRBCs, Thalidomide + Prednisone since June 2010 with positive effect, don't need iron chelation any longer, take one Neupogen injection/week instead of 2 for my low WBCs, last counts HGB 130, WBCs 4.8 and platelets 95.
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