Revlimid chemotherapy is used to treat transfusion-dependent myelodysplastic syndrome (MDS) patients with deletion 5q cytogenetic abnormality with or without additional cytogenetic abnormalities. Revlimid is classified as an immunomodulatory agent and an anti angiogenic agent. Revlimid is a trade name for the drug Linalidomide or CC-5013.

Administration of Revlimid

• Revlimid is administered in the form of capsules orally. These should be swallowed with a glass of water and should not be broken, chewed or opened.

• Do not miss the scheduled dose. If you forget to take it, take it as soon as you remember the same day or the next day. Do not take 2 doses at the same time, keep a proper gap.
• Store revlimid at room temperature, i.e. 15o to 30o C.
• The exact dosage and schedule is decided by the doctor based on the patient’s blood counts, height, weight and overall health. The doses are adjusted as per the previous response to the treatment and the tolerance to side effects.

Working of Revlimid

The exact mechanism of action of revlimid on the cancer cells is still unclear. However, it inhibits the growth of new blood vessels i.e. angiogenesis in the tumors. This decreases the production of cytokines or the growth factors. The endothelial cells lining the blood vessels are capable of dividing to form new blood vessels through a complex process called angiogenesis. This process occurs in the healthy as well as the cancer cells. Apart from anti angiogenesis, revlimid also works as an immunomodulatory agent that has a positive effect on the immune system due to the decrease in the cytokines. These cytokines play a role in survival and growth of the cancer cells. This also affects the genes contributing in the growth of the cancer cell especially the ones associated with cytokines, apoptosis and metabolism.

Side Effects of Revlimid Chemotherapy

Like any other chemotherapy drug, revlimid too has its share of side effects. Some of the common side effects are-

• Low blood counts- Decrease in the number of white blood cells, red blood cells or platelets that leads to decreased immunity, anemia or unexplained bleeding and bruising.

• Diarrhea
• Itching and skin rash
• Fatigue and weakness

A rare but a serious side effect of Revlimid is deep vein thrombosis (DVT) and pulmonary embolus (PE). It is essential to get immediate medical help in case if the patient develops chest pain, swelling on arms or legs, pain, warmth and redness on the skin that could be due to blood clotting and shortness of breath.

Precautions for Revlimid Chemotherapy

• Inform your doctor about any other medications or treatments you are receiving. This includes even the supplements, herbs, OTC medications, alternative therapies like acupuncture and prescribed medications.

• Do not get yourself immunized against any disease with a live vaccine without your doctor’s approval.
• The chemical structure of revlimid is similar to thalidomide a drug that causes severe, life-threatening birth defects. Hence, it is mandatory to inform your doctor in case pregnancy or plans to conceive a child. If a woman conceives, this medication should be stopped immediately as it harms a developing fetus. There have been cases where some pregnant women were prescribed thalidomide and their babies were born without limbs or some other defects. This was a huge scandal.
• Even males who have undergone vasectomy and undergoing revlimid chemotherapy should practice safe sex with barrier methods as there a certain amount of risk from the semen to a developing fetus.
• Do not breast feed while taking revlimid as it could enter the breast milk and harm the baby.

Revlimid chemotherapy is used as a single drug or in combination with some other anti myeloma drug called dexamethasone. This therapy is called revlimid-dex has proved effective than any other single dose drug.