ANC and Full dose of Pegasys

[Healed24]

Hello to all. I have a question regarding ANC and Pegasys doses. I want to know what is the lowest ANC you can have (even if you are being treating with Neupogen)and still remain on the full dose of Pegasys? I am on week 23/48 and  I was on a reduced dose of Pegasys (135ml)from week 2 to week 22. My ANC had dropped from 2000 to 200 and my Pegasys dose was reduced. After being treated with Neupogen my ANC increased to 1200 and my doc put me back on the full dose (180ml). Although he did say that if they drop too much I will go back on the 135ml, so I want to know what is the lowest ANC you guys have had and remained on the full dose?

Personal Stats:
GENO: TYPE 1A
VIRAL LOAD BEFORE TX: 208,000
UNDECTABLE AT WEEK 11 (<10UL)
HAD VIRUS FOR 7 YEARS
STAGE 0, GRADE 0
WEEK 23/48

Brooke
GOD BLESS

[jmjm530]

I can only answer your question generally because I really don't know all the facts.

The purpose of getting a PCR now is to simply make sure you're still non-detectible after your dosage reduction.  Depending on the results, you and your doctor may want to re-evaluate treatment.

If it turns out you're still non-detecible, then I would assume your doctor would continue with Neupogen unless it was for some reason contraindicated.  My doctor intervenes with Neupogen with ANC around 200-300 but I really dont know what they do if ANC falls below that while on Neupogen. I assume they then reduce Pegasys here, but really can't advise.  

Good luck and let us know how things are going. Hopefully, you will still be non-detectible and with the Neupogen be able to maintain your full dose. However, even if you have to reduce your Pegasys, that does not mean you will not SVR.

-- Jim

[go-girl]

Thank-you, very well explained, I shall save that for future reference.

[Healed24]

Thanks for responding. I am going to insit on a PCR as soon as possible (I just hope I don't have to whine too much). I have been on neuopgen since week 12 OR 13. My doc said he waited so long because he didn't like the possible side effects of the meds and he wanted to see if I would respond to the treatment at all. I know now that he waited to long, but unfortunately what's done is done. After my first shot my ANC dropped to 200 and pretty much stayed the same until week 12 when it dropped to 100 and he gave me the neupogen (I did my PCR at week 11 and was <10ul).So basically your saying I should request a PCR, stay on the neupogen (although I've been on it for 10 weeks now my ANC has only reached 1200), and if my ANC stays above 400 I'm good on the full dose? I just want to have as much info as possible so if it drops again I can stay on the full dose as long as possible.

Thanks
Brooke
GOD BLESS

[mikesimon]

Thanks for the sites. The stem cell report is very exciting! Mike

[go-girl]

Is neutrophils what is called ANC?  I'm about to start tx soon, so I take  this gives me lots of leeway to come down, does it? My Hemolobin 145  RANGE IS 120--150 again my #'s are different than whats being posted, what is that on your scale? Thanks so much for your help, I'm trying so hard to understand everything, there is alot to this. I hope to stay on full strength meds so I can give the bugs a good fight for the money, so sure hope my white & red bloodcounts stay up. My platelets are 200 so thats good as well, now the platelet #'s are the same as everyone posting. I'm Canadian, theres been changes made since I've started keeping my lab printouts, our diabetic readings are also different than US, it makes it harder to compare, for me anyhow. Again thanx, much appreciated

[Pirategold]

NEU 4.5 means 4,500.  That is very high!  YOu have a very strong immune system.


Pirate

[Pirategold]

That means your WBC is 7.5.  That is pretty high!

Pirate

[go-girl]

Is ANC the WBC DIFFERENTIAL? my #'s are so different than everones, do different labs interpret differently, I'd like to compare mine with these posts but can't hmmmmm here is my WBC,

NEUTROPHILS 4.2  RANGE 2.0--7.5
LYMPHOCYTES 2.4        1.0--3.0
MONOCYTES   0.8        0.1--1.0
EOSINOPHILS 0.1        0.0--0.5
BASOPHILS   0.0        0.0--0.2

I am within range, just wondered how  can compare #'s with you?

[jmjm530]

I remained on full dose with ANC in 400's. It rebounded back by itself to 800's then next week.

Where I'm confused is that it appears they reduced your Pegasys before they gave you Neupogen? It should have been the other way around and why did it take them 19 weeks to act?

That said, your stats are favorable and hopefully you don't weigh too much and the peg reduction will have a minimal effect.

If it were me, I'd insist on another PCR right away to make sure I'm still undetectible . If it turns out you're still undetectible -- which my guess you are -- then I'd continue on as is but insist on earlier Neupogen intervention.  If it turns out you had a viral breakthrough, you could either extend treatment or simply stop and treat another day, perhaps with better drugs. You have no liver damage so you have a lot of options here.


-- Jim