Prednisone

[Mseth]

Hi all,

A senior doctor, who we consult occasionaly in another city, has advised my mother to try Prednisone(20 mg) + Danazol combination. Another patient in India who has a MDS dx, has responded well to Prednisone + Darbapoeitin combination.
My questions:
1. What is the role of prednisone, Is it given in combination with other treatment to improve the efficacy of the treatment or to reduce side effects of the treatment?
2. Can Prednsione be given to a person with hypercellular bone marrow?
3. My mother is currently on EPO shots, could prednisone improve the response chances?
4. What is the optimal dose to start with?

Thanks

[Birgitta-A]

Hi Mseth,
Prednisone can be given alone or in combination with other drugs. I have tried both and had no effect with Prednisone alone, positive effect with combination with Thalidomide and a little effect with combination with Revlimid.

I have never read that Prednisone can't be given to a patient with hypercellular bone marrow or about a positive effect together with EPO.

Prednisone has a lot of serious adverse effects and should only be given during short periods. A common starting dose is 30 mg but as your mother is a small woman 20 mg should be OK as a starting dose. The drug is given during 4 weeks and is then tapered during 2 months.

A common adverse effect is sleeping problems so your mother will probably need something for the night during the first 4 weeks.
Kind regards
Birgitta-A

[Mseth]

Hi Birgitta-A,

Thankyou for responding.

Regards.

[Mseth]

Hi Birgitta-A,

Does Prednisone lead to lowered blood counts initially?

[Birgitta-A]

Hi Mseth,
No Prednisone is supposed to increase counts. Before Promacta and Nplate it was a very common drug for patients with thrombocytopenia (ITP).
Kind regards
Birgitta-A

[Mseth]

Hi Birgitta-A,

I was told that Prednsione could be used if the Coombs test result was positive, i presume it meant if there was an autoimmune hemolysis. My mothers coombs result is negative. I think Prednisone has many roles and many uses, the doc says the risks outweigh the possible benefit, as my mother is fine(other than blood transfusions), he does not wish to disturb the balance.

[Birgitta-A]

Hi Mseth,
Yes, Prednisone really has many adverse effects like risk for osteoporosis.
Kind regards
Birgitta-A