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Hello Dr Indranil, Hope You Are Doing Great ! This
Question: Hello Dr Indranil,
Hope you are doing great !
This is regarding my mother who is a Myeloma patient since 2011. I followed up with you many times if you remember for her future plans.
She got first relapse last year after 8 years of remission in the month of XXXXXXX 2019 where M band showed up value 1.1 g/dl in her serum electrophoresis report and Kappa Lambda ratio touched the mark of 5.0. That was also because she stopped taking Lenelidomide from past five months prior XXXXXXX 2019. Doctor adviced for carfilozomib and dexa weekly for 3 weeks and one week gap afterwards. She took 9 times carfilozomib+dexa till 13th March. And after that we've not visited hospital due to risk of Covid-19 virus and avoiding for the time being till conditions improve. Her current report for FLC (Last tested on 27th March) was absolutely normal with normal kappa, XXXXXXX value and the ratio (Report attached).
As she is not looking forward to go to Hospital for now and may be for few more weeks. Please suggest if it is ok to consume the medicine Lenelidomide 5 mg or 10 mg whatever you recommend to let the values remain normal till the time she visits hospital again and continue with Carfilozomib+Dexa again.
Thanks And Regards,
XXXXXXX XXXXXXX
Hope you are doing great !
This is regarding my mother who is a Myeloma patient since 2011. I followed up with you many times if you remember for her future plans.
She got first relapse last year after 8 years of remission in the month of XXXXXXX 2019 where M band showed up value 1.1 g/dl in her serum electrophoresis report and Kappa Lambda ratio touched the mark of 5.0. That was also because she stopped taking Lenelidomide from past five months prior XXXXXXX 2019. Doctor adviced for carfilozomib and dexa weekly for 3 weeks and one week gap afterwards. She took 9 times carfilozomib+dexa till 13th March. And after that we've not visited hospital due to risk of Covid-19 virus and avoiding for the time being till conditions improve. Her current report for FLC (Last tested on 27th March) was absolutely normal with normal kappa, XXXXXXX value and the ratio (Report attached).
As she is not looking forward to go to Hospital for now and may be for few more weeks. Please suggest if it is ok to consume the medicine Lenelidomide 5 mg or 10 mg whatever you recommend to let the values remain normal till the time she visits hospital again and continue with Carfilozomib+Dexa again.
Thanks And Regards,
XXXXXXX XXXXXXX
Brief Answer:
Yes that is one option
Detailed Answer:
Hi
Thanks for reaching again.
The reports are quite normal. I think it's reasonable to continue lenalidomide 10 mg for the time being, to avoid hospital visits.
If this keeps disease under control, no need to change treatment. If it starts rising again, then going back to carfilzomib can be considered.
Hope this helps.
Regards
Yes that is one option
Detailed Answer:
Hi
Thanks for reaching again.
The reports are quite normal. I think it's reasonable to continue lenalidomide 10 mg for the time being, to avoid hospital visits.
If this keeps disease under control, no need to change treatment. If it starts rising again, then going back to carfilzomib can be considered.
Hope this helps.
Regards
Above answer was peer-reviewed by :
Dr. Raju A.T
Hello Doctor,
Thank you for valuable advice.
She will be taking Leneledomide 10 mg as suggested. Does she also need to consume Dexamethason with it. If yes what should be the frequency and the quantity (mg).
I am also curious to know What is the normal practice (if we don't consider lockdown situation) if a patient consume Carfilozomib for some time and reports comes to normal after few cycles. Would that patient be suggested to come back to Leneledomide normally as maintenance after carfilozomib+ Dexa.
Thank you for valuable advice.
She will be taking Leneledomide 10 mg as suggested. Does she also need to consume Dexamethason with it. If yes what should be the frequency and the quantity (mg).
I am also curious to know What is the normal practice (if we don't consider lockdown situation) if a patient consume Carfilozomib for some time and reports comes to normal after few cycles. Would that patient be suggested to come back to Leneledomide normally as maintenance after carfilozomib+ Dexa.
Brief Answer:
Usually carfilzomib dexa is continued
Detailed Answer:
Carfilzomib dexa is usually continued beyond 3 cycles. infact it should be continued as long as disease controlled and patient can take it.
But considering present situation, only lenalidomide maintenance is justified. Dexa is usually not given with it.
Usually carfilzomib dexa is continued
Detailed Answer:
Carfilzomib dexa is usually continued beyond 3 cycles. infact it should be continued as long as disease controlled and patient can take it.
But considering present situation, only lenalidomide maintenance is justified. Dexa is usually not given with it.
Above answer was peer-reviewed by :
Dr. Kampana
Thanks Doctor ! She has started taking Lenelidomide already. She is currently experiencing numbness in her feets (may be because of neuropathy) as a medicine side effect. I would really appreciate if you suggest any medication that can be taken to minimize neuropathy effect. In future if we may easily be able to visit Hospital..Once covid-19 situation improves. Is there any chance Dr may ask to switch back to Carfilzomib Dexa from Lenelidomide or we may be asked to continue taking Lenelidomide at that time as well. I am extremely delighted with your magnificent suggestions and responses. You have become online XXXXXXX for me and my family. God bless you and your family. Take good care of yourself in this crucial time of covid-19 spread. With Regards, XXXXXXX XXXXXXX
Brief Answer:
doctor may ask you to switch back to carfilzomib dexa
Detailed Answer:
It is possible that doctor may ask you to switch back to carfilzomib dexa once situation improves, even if disease controlled.
For neuropathy we often use duloxetine 30 mg at bedtime. Do consult with her doc regarding medicine to be used.
doctor may ask you to switch back to carfilzomib dexa
Detailed Answer:
It is possible that doctor may ask you to switch back to carfilzomib dexa once situation improves, even if disease controlled.
For neuropathy we often use duloxetine 30 mg at bedtime. Do consult with her doc regarding medicine to be used.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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