Up at o’dark thirty and drove to St. Luke’s Hospital in Twin Falls, Idaho to have my blood tested and visit with the oncologist. Discussed decreasing the Dex from 40 mg to 30 mg weekly, and Dr. Padavanija is NOT IN FAVOR. All the research on Pomalidomide indicates it works BEST in the present of Dex. So, I took the 10 mg of Dex that shorted myself on Tuesday. Will try dividing the dose 20 mg on Tuesdays and 20 mg on Wednesdays.
We also discussed changing from injectable Fragmin to the new oral anti-coagulant medication Xarelto. Dr. Padavanija is going to consult Dr. Smith on this this. I’D LOVE LOVE LOVE to get rid of those daily injections! Neither Fragmin nor Xarelto have a reserval agent.
All of my blood values are decreased over the last 10 days since I started Pomalidomide 4 mg on 5 Mar 2013 (17 doses out of the 21 scheduled).
White blood cell count (WBC) down to 1.8 (norms 4.5-11); Absolute Neutrophil Count (ANC) down to 0.89 (norms 1.9-8.8); Hemoglobin down to 9.1 (norms 12-15); and Platelets tanked at 43 (norms 140-440). My LDH was normal at 505 (norms 313-618).
May have to adjust the pomalidomide dosage or interrupt Pomalyst treatment if my ANC value continues to drop from current 0.89 value to below 0.50. Also, platelet values are evaluated and treatment is interrupted for values less than 25 and reduced dosage to 3 mg for values of 50. Will have my blood tested again, Wed, 27 Mar 2013.
My kidney function tests are all abnormal this week. Creatinine 1.14 (norms 0.52-1.04); BUN 21 (norms 7-17); GFR 51 (norms > 60).