[tytd]

Hi Greg,
First of all, thanks so much for all your entertaining and informative posts. You have a great way of explaining complicated things in simple, understandable ways. I have to agree with the others, I think if I was in your situation that I would go with the Revlimid if the every other week transfusion schedule is getting too onerous. Of course, you are lucky that you appear to have plenty of time to make this decision since you can always fall back on transfusion. I'm sure that you already know the reported anemia response rates to Revlimid (in non 5q patients) as being about 26% for transfusion independence and about another 17% for a greater than 50% reduction in transfusion for a total response rate of 43%. I've been intrigued by Birgitta's good response to low dose Thalidomide but you don't hear many of the experts recommending that here in the U.S. I know Revlimid is the supposed next-generation drug but is it really any better than low dose Thalidomide? I'm not sure how the costs compare either. You might ask Dr. Olnes about this. I wish that I had the option of Revlimid or Thalidomide instead of Vidaza but apparently my platelets are too low to risk them and my Hb has fortunately stayed in the 9 range. By the way, are you on any other medications that could be affecting your anemia or are there any signs of hemolysis or blood loss lowering your counts? Here's hoping that your transfusion interval will lengthen again so you can put off this decision. Good Luck tytd