Home         Forums  

Go Back   Marrowforums > Bone Marrow Failure Diseases > MDS
Register FAQ Search Today's Posts Mark Forums Read

MDS Myelodysplastic syndromes

Reply
 
Thread Tools Search this Thread
  #1  
Old Fri Jan 2, 2009, 02:59 PM
DianeD DianeD is offline
Member
 
Join Date: Oct 2008
Location: Madera,CA
Posts: 7
When to start Chemo?

My husband was diagnosed with RAEB-1 in April 2008. The doctor started a regimen of Procrit which hasn't seemed to increased red blood cell count. My husband was given a transfusion in October when his HGB dropped to 7.3 and a second transfusion in December. His white blood cell count is currently 4.5, platelett count currently 69. The doctor wants to do another bone marrow test (last and only one was in April 2008). She is telling us that it is up to us to determine when to start with Vidaza, but the sooner we start, the higher the counts will be at their lowest points during the Vidaza treatment - thus minimizing dangers of infection/illness/bleeding. My husband is feeling pretty good most of time and would like to postpone beginning treatment if that is a reasonable thing to do. We must make the decision and we are feeling like we don't know enough to do a good job of that. The bone marrow results will be another piece of info that we consider, but we need advice/more info. Please give us your advice!
Reply With Quote
  #2  
Old Mon Jan 5, 2009, 02:30 PM
Birgitta-A Birgitta-A is offline
Member
 
Join Date: Oct 2007
Location: Stockholm, Sweden
Posts: 1,918
Chemo?

Hi DianeD,
Since I am very afraid of adverse reactions I am not the right person to give advice about when to start treatment with chemo. Your husbands situation is different from mine since I still donīt have any blast cells (as far as I know).

In any case Vidza is supposed to be the best drug for patients without the chromosome aberration 5q deletion (75 % of them have good effect with Revlimid). At least 58 % of the patients have some kind of hematological improvement with Vidaza.

MDS is not a disease but a syndrome – an association of several clinically features, signs and symptoms that often occur together. Some patients have good effect with Vidaza, other with Dacogen and some with the new drugs histone deacetylace inhibitors like Epival (valproic acid) or Zolinza.

If your husbands blast cells in his bone marrow have increased since April 2008 he could perhaps try Vidaza (5 days in a 28 day cycle) for 4 cycles.

There are methods coming where they look at the degree of DNA hypermethylation during the second Vidaza cycle (Vidaza is a hypomethylating drug like Dacogen). In the future we wonīt have to wait so long before we know if Vidaza or Dacogen will have effect.

http://abstracts.hematologylibrary.o...urcetype=HWCIT

Kind regards
Birgitta-A
69 yo, cx MDS Interm-1 May 2006, transfusion dependent from dx, Desferal for iron over load, Neupogen for low white blood cells, asymptomatic
Reply With Quote
  #3  
Old Mon Jan 5, 2009, 04:32 PM
DianeD DianeD is offline
Member
 
Join Date: Oct 2008
Location: Madera,CA
Posts: 7
Thanks for your reply

We appreciated your support and encouragement and the new information you gave us. For now, my husband decided to postpone the chemo that the doctor said he could start this month, watching the weekly white blood and platelet cell counts and hoping they will hold or climb - getting red blood cell transfusions as needed, which has been about every 5 weeks. The big question that we ask ourselves, and won't know until he has another bone marrow is - what are the blasts doing while we are not looking at them? Reading the forum and everything else I can, I still feel uneasy about missing something important that could make a big difference in my husband's future. Our doctor wants to stick to 7 days of Vidaza per 28 cycle - didn't seem to be aware of info to validate change to 5. Do you have a resource that recommends 5 day administration? If so, please share with us. Five sounds a lot better than seven when you are on the receiving end of the needles. Thank you.
Reply With Quote
  #4  
Old Tue Jan 6, 2009, 06:28 AM
Birgitta-A Birgitta-A is offline
Member
 
Join Date: Oct 2007
Location: Stockholm, Sweden
Posts: 1,918
Chemo?

Hi DianeD,
Thank you for the kind words !

You know that the 5 days treatmen is a relatively old knowledge - if your dr not have read about that I suspect that he isnīt up to date considering other aspects of MDS treatment either.

Here is an abstract from the American Society of Hematology 2007 - ASH is the best conference in the world for hematologists and they should all follow the abstracts even if they donīt attend the conference.
http://abstracts.hematologylibrary.o...urcetype=HWCIT
As you can see 5 days treatment gave the best result.

Then we now know that even the dose 75 mg/kvm is discussed - perhaps a lower dose could be just as effective and give less adverse reactions.
Kind regards
Birgitta-A
Reply With Quote
Reply


Thread Tools Search this Thread
Search this Thread:

Advanced Search

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

vB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Forum Jump

Similar Threads
Thread Thread Starter Forum Replies Last Post
To (continue) chemo or not chemo - that is the question! Quester Questions and Answers 12 Mon Oct 5, 2015 08:45 PM
Chemo drug used for AA (without BMT) Lucky AA 7 Fri Aug 9, 2013 01:04 AM
MDS from Chemo... No avaliable treatment?!? Jer MDS 2 Mon Jul 30, 2012 09:24 PM
Chemo treatment for MDS rdavidp MDS 4 Mon Apr 2, 2012 07:24 PM
The Doctor Came In Smileing Ear To Ear! anne&dean Drugs and Drug Treatments 2 Sun Jan 4, 2009 01:54 PM


All times are GMT -4. The time now is 09:51 AM.


Powered by vBulletin® Version 3.6.7
Copyright ©2000 - 2019, Jelsoft Enterprises Ltd.
Forum sites may contain non-authoritative and unverified information.
Medical decisions should be made in consultation with qualified medical professionals.
Site contents exclusive of member posts Copyright Đ 2006-2019 Marrowforums.org