Dear Ziad,
As you have understood it takes several cycles of Vidaza treatment to give a positive result - the adverse effects will come at once.
Here is an article about Vidaza treatment. They write
"Patients with high-risk MDS must undergo prolonged treatment with azacitidine (Vidaza) to improve their outcomes, with a median of three cycles needed before the first evidence of response appears." http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2948932/
I will try to answer your questions:
1. Vidaza is supposed to be the best treatment for MDS. I have seen reports with combination with Revlimid for better effect but that was only one trial.
2. As far as I understand it is common that the counts will decrease after the second cycle too - your father will probably have to continue to receive supportive therapy.
3. No, nausea and other similar adverse effects are often the same during the whole treatment - he is lucky.
4. As other members have written he should start early with Lactulose or other treatment for constipation.
5. Vidaza is a chemo and toxic for all cells - not only cancer cells. It is common that patients get very tired during treatment.
6. As I have written in many posts to different members increased ferritin is not an important problem for patients with a severe disease. It takes years for the iron to cause damage to the liver, heart etc. Exjade is quite toxic too.
7. You know our plateles have different quality. Mine are dysfunctional and I get petechia around the eyes, small bleedings from nose and mouth when they go down to 22. Other patients have much better platelets and manage with very low counts. They should not be transfused too early because they can be refractory.
I think your father is getting very good care
! Hope he will respond to the treatment!
Kind regards
Birgitta-A