Bmp results and Treatment

[abe]

Hello to everyone and hope your enjoying the summer.I finally received my bmp results from DF in Boston where i went to get a second opinion. The Bmp report indicated high risk MDS/CMML-2/RAEB-2.My local Doctor has started me on aranesp and i will be starting vidaza also.He said that i’ll be receiving the shots in the stomach,or i can get the vidaza thru iv if i decide to do so.I read that the shots are usually alternated between the arms,legs and stomach.I’m wondering why just the stomach?….any input woud be wonderful.

Thanks abe

[eve]

hi abe

my dad took the shots mostly in the stomach because he found them to be less painful in that area – but as the years went on he would alternate between stomach, arms and thighs

good luck to you

eve

[lynette]

Abe,
I believe that the medication is absorbed better in the abdomen. However, Eve is correct, most patients report less pain in that area.
Good luck!
Lynette

[Neil]

Hi abe,
I have been getting Procrit and now Aranesp for a bit over 4 years. All in the stomach. No pain at all after a little pin prick.
Cannot address Vidaza except for a couple questions for you to bounce off your doc.
I looked at your counts in your first post and assume they are much the same.
You can expect your counts to go down shortly after you start on Vidaza. —Before they begin to go up.
Your doc is supproting your red counts with Aranesp.
At what ANC level will they begin to support your white cell counts?
At what platalet level will they consider platelet TX?
What will the starting Vidaza dosage be?
Since vast majority of patients experience a drop in counts with the traditional starting dosage would it not be wise to start at a lower level and work up over time to a point where the drug becomes effective.
Many docs withdraw the drug after counts go down and resume it later.
Would starting at a lower level minimize the drop in counts thus avoiding the possible withdrawl. This might take longer at the front side but might prove more effective long term.
These are questions I have developed for my doc. I can see the probability of going on Dacogen or Vidaza in the not too distant future and had this conversation with other patients and knowledgeable sources.
Am more than curious about the response at your end.

[jaxem]

neil
not clear what you mean “start at a lower level and . . . . .” if you’re alluding to blood cell counts, then i would think you always want to start as high as you can get because most treatments are going to drive the counts down which may become critical to sustaining life. i haven’t heard of docs withdrawing drugs such as the hypomethylating drugs vidaza and dacogen because of the regimented round cycles of 4 and 6 weeks, respectively. these drugs are ineffective over the short term. i think it’s up to the docs to build up the patient during the rounds so they can withstand each of the 4 rounds in succession. it’s critical to get blood checks twice/week for this reason. withdrawal from a round should only be done for serious health issues as decided by the doc.

[Neil]

Hi Jack,
By starting at a lower level I mean begin the Vidaza dosage at a level lower than usual.
There are patients who had their program stopped as a result of their counts decreasing to a very low level. Aranesp or Neupogen or Platelet TX were not effective in keeping counts up. Some of these patients returned to Vidaza after a while and when their counts increased. The point I was making was to start at a lower dosage of Vidaza/Dacogen in an attempt to minimize the drop in counts and let the drugs become effective at a slower pace.
My question was “What will the starting Vidaza dosage be”.

[frank]

i withdrawed myself off the vidaza after the 1st round, my wbc is so low and an infection happened, staying in hospital for a week for the infection, and then stay another 10 days for drug reaction. be really careful and prepared on it, anything may happen, just discuss with your doctor first, and let him monitor the counts carefully, and away any source of bugs.

i think Neil has a good point od this, if i start any chemo again, i will start with low point first, let your body used to it, and then increase the level… but i don’t know any doctor will agree on it.

best wish.

Frank

[jaxem]

neil
i see what you are saying. the point to consider, however, is that there are so many iterations possible of administering the drug. since this is a new drug, (7/06 for dacogen), the manufacturer per the trials has strictly stated that if this drug is to work, it must be strictly administered per trial guidelines. any other administration would void stated results and possibly put the patient in danger. it is clear that in cases of infection as frank states would terminate the regimen. my thinking is that the clinic should do all it can to bolster blood levels by transfusion, aranesp, neupogen/neulasta or whatever to get the patient through the regimen at the manufacturer prescribed dose concentrations and rates. any changes to this would constitute an unapproved trial.

[Author]

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