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Myeloma Chemotherapy- Chemo-Induced Liver Inflammation

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“After 2 weeks, the tests showed liver inflammation. We have stopped the treatment for 10 days and the liver has returned normal.”

Hi Cancer Coach: Here are some news of myeloma chemotherapy and my induction therapy. The good news- I shared with the oncologist the information you gave me about the incompatibilities between vitamin C, green tea extract and Velcade. He appreciated having this information that he did not know. Currently, I do not take more food supplements to not distort the results of chemo treatment. I will take them back later. The bad news- liver inflammation.

My myeloma chemotherapy started with the usual RVD protocol (Revlimid 25 mg / Velcade 1.3 mg / m2 / Dexamethasone 20 mg) with all complementary drugs to prevent side effects. After 2 weeks, the tests showed liver inflammation. We have stopped the myeloma chemotherapy treatment for 10 days and the liver has returned normal.

As you can see in the attached file the results are excellent. The oncologist is a little surprised by the results so fast, he is of course very happy. I think all the good things I did last year are important. I hardly feel any side effects.

In the usual procedure, it is expected that after the current treatment, there is an autograft. On March 15, 2019, we will have a first interview with Prof Pabst who is the great specialist for autografts. My desire is to have a collaboration with this Professor to find a personalized way between the therapies of conventional medicine and natural therapies. I do not wish to undergo this autograft.

To prepare for this next consultation with the professor, I am currently documenting the effective natural treatments to support the body in the specific case of multiple myeloma. I must give him strong arguments.

If you still have information that is not in your “PeopleBeatingCancer.org” document I would be very happy to have it. Dottie

Dear Dottie- I have a little difficulty reading your test results in French but from what I can read your results look good. If I understand what you are saying, you underwent only one or two cycles of chemo? And you responded well despite so little chemotherapy? This is good. I agree with you. I believe your months of non-toxic therapies prepared you well to respond to RVD. Well done.
I understand what you say below about not wanting to undergo what we call an autologous stem cell transplant (what you call an autograft.) In this country an ASCT/autograft is called the “standard-of-care.” This means that yes, unless you are too old or have co-morbidites (health problems) then you have an ASCT/autograph.
Something to consider. Because your oncologist will probably push you to undergo an ASCT/autograph, you may want to think about the pros/cons/ of this procedure. The reason for it is that your MM is killed as much as possible. The con or reason for not having an ASCT/autograph is that the first two courses of your RVD showed that your liver is sensitive to the toxicity of chemotherapy and therefore caution is warrented.
I think even your oncologist would agree that an autograph/ASCT/high dose chemotherapy and stem cell rescue would be too much toxicity for your liver to manage.
On the other hand, by undergoing one or two rounds/courses of RVD only when your numbers increase enough, might be the best path forward for you. You likely will have lots of relatively short remissions but longer overall survival.
Just an idea. Keep me posted. Hang in there,
David Emerson
  • MM Survivor
  • MM Cancer Coach
  • Director PeopleBeatingCancer

Recommended Reading:

Chemotherapy hepatotoxicity and dose modification in patients with liver disease

“Patients undergoing cytotoxic chemotherapy require careful assessment of liver function both prior to and during therapy. Potential interactions between the liver and chemotherapy fall into two categories:

Direct chemotherapy-induced hepatotoxicity.

Potentiation of preexisting liver disease, especially viral hepatitis. Altered hepatic drug metabolism due to underlying liver disease can result in higher or more persistent drug levels, thereby causing increased systemic toxicity (particularly myelosuppression) or worsening of liver function because of chemotherapy-induced hepatotoxicity.

The interrelationship between the liver and chemotherapy is reviewed here. General aspects of drug metabolism and patterns of hepatic injury are discussed separately, as is reactivation of hepatitis B (HBV) viral infection in patients treated with immunosuppressive therapy, and hepatotoxicity associated with checkpoint inhibitor immunotherapy (ipilimumab, pembrolizumab, nivolumab), as used for advanced melanoma and non-small cell lung cancer…”

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