Extreme GI Reaction to Lenalidomide / Revlimid

FormerMember
FormerMember
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My Mum was diagnosed with Myeloma in 2018, which became symptomatic earlier this year. She began a treatment protocol of 15mg Lenalidomide with 40 mg Dexmethasone in August and on Day 12 experienced severe vomiting, nausea and diarrhea. She was hospitalised to administer fluids and electrolytes but they didn't provide any nutritional support for 15 days, despite the severe side effects being continuous, so she has lost an awful lot of body mass and is now very weak. All samples have tested negative for infection and ct scans and a partial colonoscopy have show inflammation throughout the gut and also the presence of ulcers. It is now day 30 and she still continues to experience diarrhea and can't keep and food down and the hospital seem clueless as to how to stop it. I appreciate this is an extreme reaction but wondered if anyone has experienced anything similar or heard about any similar cases? We need to stop the diarrhea ASAP as otherwise she will get weaker and weaker. She hasn't had any Lenalidomide or Dexamethasone for 30 days ( since her admission) but the bowel damage doesn't appear to be getting any better. Any help appreciated. Thank you.

  • My step-father was on a lenalidomide based trial 8 years ago. It made him very sick and triggered diverticulitis which led to a perforated bowel. When he went to the hospital, the team were so determined that the problems he had must be chemo related, that they only picked up the diverticulitis (he had a family history - his mother had died of it many years ago) when he was barely an hour from death. He made a full recovery after losing a length of the bowel, getting an ostomy, getting it reversed and staying in remission for a long time.  He lived 7 years with myeloma and died a year ago yesterday.

    I don't want that to sound like a horror story. He had a very good life with Myeloma for most of the time. My main purpose is to say that it's important to make sure the doctors aren't so fixated on the chemo that they miss an unrelated underlying issue. It may well be the lenalidomide that's caused this, but after so long off the drug, they need to also be checking for other possible causes. 

    Good luck and I hope the docs find a way to get her better nutritional support. 

    Best wishes

    Barbara

    “Scars are tattoos with better stories.” – Anonymous

  • FormerMember
    FormerMember in reply to barbaral

    Hi Barbara,

    Thank you for your reply. I'm sorry to hear that it was the first anniversary of your step-father's death but heartened to hear that he lived well with Myeloma for 7 years.

    My mother remains in hospital - day 43 now and is plagued by infections due to her very fragile state. They still haven't given any treatment for the bowel issues - the consensus seems to be that she has Chron's / IBD brought on by the Lenalidomide. However we are in a bit of a catch 22 as they would usually give steroids to reduce the inflammation however with them weakening the immune system further and her already having contracted several infections, that is not possible currently.

    She is on TPN which is preventing her from losing more body mass but isn't suffice alone to start building her up again, yet she can't eat or drink without severe diarrohea and vomiting due to the inflammation in the intestines.

    We continue to pray that she will get better. She has been amazingly tough so far.

    Best wishes,

    Sally