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MDS Myelodysplastic syndromes

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  #1  
Old Fri Mar 18, 2016, 03:41 PM
kyis kyis is offline
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Location: Marin, California
Posts: 56
Vidaza dosage

I just started Vidaza this week. Oh fun.
I'm confused by the dosage. I have read on the forum frontwards and backwards. Wow overwhelming.
So far not I'm not to bad, but I am backed up, hopefully something start moving today. On my 3rd day of miralax. Red and sore at injection points and nausea comes and goes.
2 units of blood prior to treatment got me to 10 hgb from 6.9.
Anyway just concerned about dosage and my counts.
My wbc has been in the 300 to 800 range for almost 2 years.
Amazingly I almost never get sick, but now I guess it going to go lower.
My dosage 86.61 or 86. something. I seem to see 50 or 100.
We are trying 5 days only at first to see how I tolerate and how my counts do. They said they cut the dosage in half. Does this make sense?
Thanks so much for any replies!
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Male 56, MDS 2008, pre SCT Hypocellular 5-30%, Normal Cytogenetics. WBC 500, anc 45, Blasts 15%, Platelets 45, HGB 7, RBCC 1.71, HCT 20.5, MCV 120. Became Transfusion dependent 3/2016. 5 cycles VIdaza started 3/14/16 which reduced Blast counts. . Marrow Transplant 9/1/16, Hereditary MDS/AML.

Last edited by kyis : Fri Mar 18, 2016 at 03:48 PM. Reason: wrong title
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  #2  
Old Fri Mar 18, 2016, 04:35 PM
bailie bailie is offline
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My dosage is 75 mg/m2. This is the standard dosage which is determined by your weight (I am 205 lbs.). Are you on anti-nausea pills? It does seem that everyone has a different experience with Vidaza. Constipation is a big concern. I am in the middle of my Vidaza cycle (7 days) right now. I am on the 11th cycle with one more to go.

Counts will go lower before recovering. My platelets are lowest about 8-10 days after treatment.
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age 70, dx RAEB-2 on 11-26-2013 w/11% blasts. 8 cycles Vidaza 3w/Revlimid. SCT 8/15/2014, relapsed@Day+210 (AML). Now(SCT-Day+1005). Prepping w/ 10 days Dacogen for DLI on 6/9/2017.
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Old Fri Mar 18, 2016, 06:35 PM
Cathy C Cathy C is offline
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I had my first round of Vidaza last week. I got sick the first day then took zofran an hour before my shots the rest of the week. I too got backed up and took Colase and it worked. I get 3 shots each day. My white blood count dropped very low and I did not get my last 2 days of shots.
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Old Fri Mar 18, 2016, 09:36 PM
kyis kyis is offline
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I'm glad to know I'm not having all this fun alone.

I'm 230 lbs at 6ft.
Yep have Zofran, usually take about 1 hour before.
I seem to have waves of nausea. Always good 1st thing in the morning then starts up, but not to bad. Could be related to constipation now.
What were your wbcs before treatment?
Cathy how low is very low?
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Male 56, MDS 2008, pre SCT Hypocellular 5-30%, Normal Cytogenetics. WBC 500, anc 45, Blasts 15%, Platelets 45, HGB 7, RBCC 1.71, HCT 20.5, MCV 120. Became Transfusion dependent 3/2016. 5 cycles VIdaza started 3/14/16 which reduced Blast counts. . Marrow Transplant 9/1/16, Hereditary MDS/AML.
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  #5  
Old Fri Mar 18, 2016, 10:18 PM
Barb M Barb M is offline
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Nausea

If you are still nauseous after Zofran try some good old fashion peppermint candy. I get immediate relief when I let these dissolve in my mouth.
I find the best thing for constipation is prune juice. Just drink a cup a day.
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  #6  
Old Sat Mar 19, 2016, 01:39 AM
DanL DanL is offline
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kyis,

sorry about the nausea and constipation double whammy. You might want to ask about other anti-nausea options. I am not that familiar, but there was one that I took for a couple of cycles that did not work for me, whereas zofran worked well. As for the other end of things, if your clinic has a dietitian, speak with him/her. Senna tablets are available otc and seem to work well after about a day. My magic is coca-cola or coffee.

As for the dosing, most of the time that i have seen 1/2 dosing is when the patient receives vidaza over a 10 day period instead of 5, but I do seem to recall some forum members that utilized reduced doses of dacogen (kirby comes to mind from a few years ago) with a lot of success on and off.

My vidaza schedule was always 75mg/m2 over 5 days - i completed 9 cycles. Vidaza beat the heck out of my wbc each month taking me down between 75% and 90% from baseline, so I would go from a wbc of 4k to a wbc low of 400 to 600 by about day 10 in the cycle. it rarely impacted my platelets or HGB.

Good luck with your treatment. One other common thread that I have seen is that treatment tends to get easier after about the 3rd or 4th cycle for most people.

Dan
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MDS RCMD w/grade 2-3 fibrosis. Allo-MUD Feb 26, 2014. Relapsed August 2014. Free and clear of MDS since November 2014 after treatment with Vidaza and Rituxan. Experiencing autoimmune attack on CNS thought to be GVHD, some gut, skin and ocular cGVHD. Neuropathy over 80% of body.
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  #7  
Old Sat Mar 19, 2016, 10:15 PM
kyis kyis is offline
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Join Date: Jun 2013
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Thanks Dan,
My exact dosage is 86.625. Go figure.
Finished my 1st round yesterday of 5 days.
Started stool softners and 2 seena last night.
I saw a little action this morning, but have stomach pain, headaches most of the day with a little nausea, but didn't take any Zofran today.
I'm sure I will be fine.
I'm probably more concerned about my wbc.
Yours dropped to what my baseline is, well at least I can't go negative.
__________________
Male 56, MDS 2008, pre SCT Hypocellular 5-30%, Normal Cytogenetics. WBC 500, anc 45, Blasts 15%, Platelets 45, HGB 7, RBCC 1.71, HCT 20.5, MCV 120. Became Transfusion dependent 3/2016. 5 cycles VIdaza started 3/14/16 which reduced Blast counts. . Marrow Transplant 9/1/16, Hereditary MDS/AML.
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