Saturday, March 27, 2010

The fog lifts

The fatigue that accompanied the start if my lenalidomide (Revlimid) therapy has pretty much disappeared after about three weeks. I didn't realize how bad it was until I started to come out of it and suddenly found myself with a lot more energy than I expected to have. I had started to forget what "normal" felt like. 

After therapy began on March 4, I began sleeping nine to ten hours a night and napping for perhaps an hour during the day. Even during my waking moments I was running (or I should say moseying) at about half speed. As this routine dragged on it became rather depressing. I have been fortunate in that I have not had the CLL-related fatigue that some patients report. Living with a drug-induced taste of it for a few weeks opened my eyes to how difficult it can be. 

Is the cessation of fatigue dose-dependent? I started at 10 mg daily, which was reduced to 5 mg about a week in. The fatigue still continued for awhile, though. I will no doubt attempt to step up to 10 mg again at some point in the near future. I'll just have to see if the fatigue returns.

Other than that, there is little to report so far. Blood work shows that my red counts continue to improve. There's no sign of low platelets or low neutrophils, either or both of which can accompany Revlimid therapy. It is possible that there is a slight, incremental improvement in my lymph nodes, but these can wax and wane under normal circumstances so I hesitate to read too much into it. One study put the median time to best response at 5.9 months and I haven't even been on lenalidomide for a month yet. Patience is both an art and a discipline.


robert said...

Hey David, Just had second dose of "Ofat" MDA's slang. First dose went rough, broke out in hives three times, then throat got scratchy and they shut it down after 14 hr attempt. Second dose no problem whatsoever, what can you say? Start Revlimid Monday! Who knows!

David Arenson said...

Good luck with your treatment, Robert. Hope your Revlimid is easier than your first ofat, though I wouldn't necessarily count on it.

Anonymous said...

Sounds like you are tolerating Revlimid very well. By this point, Tom was in serious allergic reaction, BUT----it does take months to see the results from Revlimid. MDACC's trial for relapsed patients using Revlimid/Solumedrol proves that point. Hang in there----I remember that fatigue thing---it is never as bad as the beginning, even when doubling your dosage.

Jenny Lou

Tom said...

It's been about a month, how are things going with your treatment?

Anonymous said...

you mentioned a study that put the median time to best response at about 6 mo. If you can recall what study was that, could you please leave a reference.