Vidaza as Consolidation therapy

[Joseph]

Dear All,

This is my first post on the forrum, and i would like to thank you all for sharing your stories and infos as i find them very helpfull...
I need to have some infos about the following:

- My Father 67 years old was treated for AML with an induction therapy using the protocol (7+3) (Cytarabine + Idarubicine)

- Following to this induction therapy, he achieved Complete Remission...Doctors advised not to continue with the standard consolidation, as he spent 60 days in hospital during the induction therapy and stayed neutropenic for 35 days !

- As consolidation, he started Vidaza (as 28 days cycle)…
After the end of the first cycle, his CBC is showing Hb 12.4, Platelets 76000, WBC 16000 (due to Neupogen shots)
Those readings were exactly the same before the first 7 days IV Vidaza cycle

My questions are the following:
- Can Vidaza be used as consolidation therapy after standard induction therapy ?
- Is it possible that Vidaza does not change any value in blood count ?

Thanks in advance…

[Birgitta-A]

Hi Joseph,
There are several trials where they try Vidaza for consolidation after AML treatment but I have only found results from this study that is from 2010 (my doctor is the first author):
http://www.ncbi.nlm.nih.gov/pubmed/20497178

It is positive that your father has so good counts - Vidaza often decreases counts initially. It can take several cycles before Vidaza has a positive effect and doctors usually wait until the patients has received 6 cycles before they evaluate the result.
Kind regards
Birgitta-A
73 yo, dx MDS Interm-1 2006, positive results with Thalidomide + Prednisone

[Joseph]

Good Day Brigitta,

Thanks for the link...

Regards,
Joseph

[Joseph]

Dear All,

I am a little worried about my father's platelets count after first Vidaza cycle.

Before injuction: platelets 116000
3 days after end of cycle: platelets 76000
8 days after end of cycle: platelets 55000

I know it is normal that platelets count go down after each cycle...

When to expect that count rise up again ? any idea ?

Regards

[Birgitta-A]

Hi Joseph,
As far as I understand the counts hopefully will increase before the next cycle after 28 days but all patients are different. The doctor will give a lower dose or delay treatment if the platelets are too low. The adverse effects often decreases after the first cycles.
http://www.vidaza.com/pdf/PI_FINAL.pdf

Kind regards
Birgitta-A

[Joseph]

Dear All,

I am a little bit worried about the WBC counts of my father 3 weeks after first Vidaza cycle.
In fact, HB kept the same level 12.5
Platelets went up to stay around 90000
WBC decreased to 2900...

Is this normal with Vidaza ?

Thanks

[DebS]

Joseph,

Blood counts are very erratic with Vidaza or so my husband and I have found. They have to be monitored very closely in the beginning. My husband is on round 3 and is responding very well. We feel extremely lucky and blessed.

Keep asking questions of the doctors. Someone needs to explain the blood counts to you. Believe me, I have been a "pain" by asking a lot of questions, but it is the only way to stay informed.

Good luck!

[Joseph]

Dear All,

After the 2nd Vidaza Cycle as consolidation therapy, a bone marrow showed blasts...

I am wondering what is the alternative now ?
Knowing that my Father is 68 years old with AML M0, had already Standard Induction Therapy (3 + 7 Idarubicin & Cytarabin), achieved a Complete Remission but relapsed, after the 2nd Vidaza cycle that we tried as consolidation...

Is Palliative treatment the best for him to ensure a minimal quality of life ?

Thanks

[Birgitta-A]

Hi Joseph,
You know Vidaza almost always has to work for at least 4 cycles. Most doctors wait during 6 cycles before they know if the patient is responding.

Do you know how much blast cells the BMB showed? If it was very high (more than 20%) he perhaps should try some other treatment. Blast cells are very young blood cells and we should have them in our bone marrow but less than 5%.
Kind regards
Birgitta-A

[LJacobs]

Dear Joseph,
I wanted to speak up and let you know that for my Dad (who has AML) it took more than 7 cycles for the Azacitidine (Vidaza) to show positive results. I hope the doctors give it a while to take hold and I hope that the treatment gives your Dad some good results.

My Dad had 26% blasts in his peripheral blood when he was diagnosed with AML. The only drug he's received has been Vidaza (due to his age and the fact that he has a heart condition). He did really well on that single drug for over a year.

Sending you some good positive energy and calm...
Lesley

[Joseph]

Dear All,

Thanks for your infos and explanations...

Latest bone marrow showed 35 % blasts @ the Second Vidaza cycle...

Dr. did not take a decision yet but informed me that might switch to standard low dose cytarabine as supportive care....

I already know that a relapse after a CR is not a good prognosis, and i am trying to make sure that the best is being offered to Dad...

From lesley's experience, Vidaza kept on holding blasts and insure a minimum quality of life, the question is would it do the same with Dad ?

I feel a little hesitatting especially that vidaza effect is different on each patient....perhaps the low dose cytarabine will hold his blasts a little....

Anyone experienced low dose cytarabine ?

Thanks

[Joseph]

Dear All,

I am wondering if someone has some infos regarding treatment with Vidaza + Sorafenib for a relapse AML with FLT3 positif mutation...

I know that there is a phase II trial ongoing in the US and i would like to have additional infos....

Thanks