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(Because the question was in English, I’ll answer in English first - and this can be translated to Vietnamese later) Many thanks for sharing your experience and for your questions. Unfortunately because of lack of a complete medical records and particularly also because of medico-legal implications, I will not be able to present to you my answer specifically about THIS case (note: for these same reasons, I've therefore declined to render my opinion about specific cases sent to me via the Internet). However, in reading your case some thoughts come to mind: (1) Is bleeding in this case related. | Thuốc Bortezomib- Velcade Because the question was in English I ll answer in English first - and this can be translated to Vietnamese later Many thanks for sharing your experience and for your questions. Unfortunately because of lack of a complete medical records and particularly also because of medico-legal implications I will not be able to present to you my answer specifically about THIS case note for these same reasons I ve therefore declined to render my opinion about specific cases sent to me via the Internet . However in reading your case some thoughts come to mind 1 Is bleeding in this case related to Bortezomib 2 If not then what is the mechanism of bleeding in this case Chemotherapy induced bleeding occured infrequently although thrombocytopenia is seen commonly in oncology patients. Nadir platelet count usually appeared from 7-15 days after chemotherapy for other chemotherapy agents and about day 15 for bortezomib Ref. S. Lonial see below Note in this case the first dose of Velcade was given on April 23 2008 and bleeding appeared on April 27 which is only on day 5 . One may argue that in this specific case patient had been treated with other chemotherapy agents Melphalan therefore his bone marrow has been suppressed and therefore thrombocytopenia appeared earlier. This assumption may not be correct - because if it is the case then severe pancytopenia already had been observed on April 23 2008 - and this pancytopenia would prevent the oncologist to initiate Velcade on the same date. Thrombocytopenia has been associated with Bortezomib incidence 24-28 S.Lonial et al Risk factors and kinetics of thrombocytopenia associated with bortezomib for relapsed refractory multiple myeloma Blood 1 Dec 2005 Vol 106 No 12 pp 3777-3784 . The mechnism of thrombocytopenia associated with bortezomib also was speculated in this article http bloodj ournal.hematolo gylibrary.org cgi content full 106 12 3777 The authors of this article also noted There were no reports of .
