Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Is The Ideal Dosage Of Revolade Taken For Bone Marrow Suppression?
Question: Dear Doctor,
My mother aged 63 years is suffering from 4th stage peripheral T cell lymphoma since October 2014. She has a haemoglobin level of 5.2 and platelet count of 12000. She had been given 3 cycles of COEP and then 2 weeks of PEP-C which essentially reduced her weight by 5 kgs and did not give any benefit whatsoever. We had stopped all forms of chemo after severe bone marrow suppression.
The treating doc had administered 500 mcg of cresp injection (darbapoetin alfa) once every 3 weeks and 25 mg of revolade tablets once every week.She has a resting BP of 110/60 and pulse of 95.
Can you please confirm whether the dosage of the medicines given, are normal for a lymphoma patient?Also if her BP and pulse rate can be considered normal? Thanks a ton.
Dear Team,
Please can we have Dr. XXXXXXX XXXXXXX to answer my question?He had answered my query regarding my mom on 23.10.2014 on this board and might remember the case.Please note that I have uploaded the blood test reports done on 13.05.2016. The pwd is swap1950. The hgb and platelet levels have decreased since then. Thanks.
My mother aged 63 years is suffering from 4th stage peripheral T cell lymphoma since October 2014. She has a haemoglobin level of 5.2 and platelet count of 12000. She had been given 3 cycles of COEP and then 2 weeks of PEP-C which essentially reduced her weight by 5 kgs and did not give any benefit whatsoever. We had stopped all forms of chemo after severe bone marrow suppression.
The treating doc had administered 500 mcg of cresp injection (darbapoetin alfa) once every 3 weeks and 25 mg of revolade tablets once every week.She has a resting BP of 110/60 and pulse of 95.
Can you please confirm whether the dosage of the medicines given, are normal for a lymphoma patient?Also if her BP and pulse rate can be considered normal? Thanks a ton.
Dear Team,
Please can we have Dr. XXXXXXX XXXXXXX to answer my question?He had answered my query regarding my mom on 23.10.2014 on this board and might remember the case.Please note that I have uploaded the blood test reports done on 13.05.2016. The pwd is swap1950. The hgb and platelet levels have decreased since then. Thanks.
Brief Answer:
Will it be okay if I answer the question
Detailed Answer:
Please let me know
Will it be okay if I answer the question
Detailed Answer:
Please let me know
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Sure Dr. XXXXXXX Also I would like to know whether you have any idea about denvax protocol done by Dr. XXXXXXX XXXXXXX whether it is safe and whether it is really effective in curing lymphoma as claimed by him. Thanks.
Brief Answer:
low blood parameters due to bone marrow involvement
Detailed Answer:
Hi
I have gone through your previous question which was answered by Dr XXXXXXX It appears that she has bone marrow involvement due to lymphoma from the very beginning and now blood counts have dropped markedly. It also appears that chemo didn't work and now she is on supportive treatment only. Her pulse and BP appears fine.
The low counts are likely due to bone marrow involvement due to lymphoma and little can be done for that apart from blood or platelets transfusion when required. Darbepoietin and revolade can be tried but I personally feel that response is unlikely (but not impossible). Dose of darbepoietin is OK but that of revolade is too low for me. It is usually given daily, but the treating doctor must have some reason for this reduced dose which I am unaware of.
The denvax protocol does not have much publications in literature so it is not accepted by most oncologists. I have no personal experience with it.
Hope this helps.
Regards
low blood parameters due to bone marrow involvement
Detailed Answer:
Hi
I have gone through your previous question which was answered by Dr XXXXXXX It appears that she has bone marrow involvement due to lymphoma from the very beginning and now blood counts have dropped markedly. It also appears that chemo didn't work and now she is on supportive treatment only. Her pulse and BP appears fine.
The low counts are likely due to bone marrow involvement due to lymphoma and little can be done for that apart from blood or platelets transfusion when required. Darbepoietin and revolade can be tried but I personally feel that response is unlikely (but not impossible). Dose of darbepoietin is OK but that of revolade is too low for me. It is usually given daily, but the treating doctor must have some reason for this reduced dose which I am unaware of.
The denvax protocol does not have much publications in literature so it is not accepted by most oncologists. I have no personal experience with it.
Hope this helps.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr. XXXXXXX
Thanks a ton for your answer. We are just worried about the side effects of these 2 medicines.Can you please let us know whether these 2 medicines can cause heart attack/ stroke/ blood clots? Also will you be able to kindly tell us about any clinical trial in the US/UK for t cell lymphoma? Also judging by the reports can you please tell us frankly what is her chance of succumbing to the disease?Her LDH was 172( higher limit is 192) while her beta 2 microglobulin is around 5233( highest limit 2200) both tested at XXXXXXX Asia on 15.04.2016.
We don' t know for how long this transfusion is going to continue as it is too painful for her, being done every week.Thanks a ton for your advice.
Thanks a ton for your answer. We are just worried about the side effects of these 2 medicines.Can you please let us know whether these 2 medicines can cause heart attack/ stroke/ blood clots? Also will you be able to kindly tell us about any clinical trial in the US/UK for t cell lymphoma? Also judging by the reports can you please tell us frankly what is her chance of succumbing to the disease?Her LDH was 172( higher limit is 192) while her beta 2 microglobulin is around 5233( highest limit 2200) both tested at XXXXXXX Asia on 15.04.2016.
We don' t know for how long this transfusion is going to continue as it is too painful for her, being done every week.Thanks a ton for your advice.
Brief Answer:
life expectancy is difficult to predict
Detailed Answer:
There is every possibility that she will eventually succumb to this, but life expectancy is difficult to predict and more so without seeing the patient. Wild guess is a few months.
darbepoietin can cause clots/stroke but fortunately not so common unless hemoglobin is allowed to rise very high, which I think is a rare possibility for her.
there are many trials available. I have run a search, the results are available in the link below
https://clinicaltrials.gov/ct2/results?term=t+cell+lymphoma&recr=Open&cond=%22Peripheral+T-cell+Lymphoma%22
life expectancy is difficult to predict
Detailed Answer:
There is every possibility that she will eventually succumb to this, but life expectancy is difficult to predict and more so without seeing the patient. Wild guess is a few months.
darbepoietin can cause clots/stroke but fortunately not so common unless hemoglobin is allowed to rise very high, which I think is a rare possibility for her.
there are many trials available. I have run a search, the results are available in the link below
https://clinicaltrials.gov/ct2/results?term=t+cell+lymphoma&recr=Open&cond=%22Peripheral+T-cell+Lymphoma%22
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr. XXXXXXX
Need to confirm from you one thing-can she take beetroot and carrotroot? As beet root has folic acid and B12 and we were told by some that it might enhance ehr lymphoma-is that true? We believed folic acid helps in increasing HGB.
Also, can you please let us know, if 200 mcg of cresp is safe to give her once a week as this has been suggested by another consultant, junior to the treating doc, at TMC? She had bouts of loose motion and fever most probably due to revolade-she had 5 tabs of revolade but we have stopped the med following advice by the doc at Columbida Asia.Thanks.
Need to confirm from you one thing-can she take beetroot and carrotroot? As beet root has folic acid and B12 and we were told by some that it might enhance ehr lymphoma-is that true? We believed folic acid helps in increasing HGB.
Also, can you please let us know, if 200 mcg of cresp is safe to give her once a week as this has been suggested by another consultant, junior to the treating doc, at TMC? She had bouts of loose motion and fever most probably due to revolade-she had 5 tabs of revolade but we have stopped the med following advice by the doc at Columbida Asia.Thanks.
Brief Answer:
yes she can take beetroot and carrotroot
Detailed Answer:
Some vitamins will not stimulate her lymphoma at this stage.
Revolade may be stopped if causing too much side effects. It's efficacy in this situation is doubtful.
Cresp 200 ucg can be given 2 weekly, not weekly. The weekly dose is 100 ucg. She can try either of these.
yes she can take beetroot and carrotroot
Detailed Answer:
Some vitamins will not stimulate her lymphoma at this stage.
Revolade may be stopped if causing too much side effects. It's efficacy in this situation is doubtful.
Cresp 200 ucg can be given 2 weekly, not weekly. The weekly dose is 100 ucg. She can try either of these.
Note: For further queries related to kidney problems Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
