Blood counts

Hi everyone!  I know I haven't posted in a while, but things have been fairly okay lately.  Sides have let up a little and I am feeling pretty good for the most part.  As most of you who know me, you know that I am on daily Infergen and Riba.  My white count dropped to below 2 about two weeks ago, so the doc made me reduce the injection to 1/2 dose.  It hasn't come back up enough to put me back on full dose.  Now, my red count has dropped and now I have to reduce my Riba dose to 1/2.  Could someone tell me what all this means.  My white count is 2.6 and my red count is 2.66.  I am the first patient that my doc has prescribed Infergen to, so he won't consider putting me on Procrit or Neupogen or anything like that.  He is just telling me to 1/2 the dose until the levels come back up.  Also, could someone give me some input on what happens to the body with the red and whites being so low.

Hope all is well with everyone.

Linda

[cuteus]

Having your doses reduced early in tx, might decrease your chances at SVR. This dr knows that you did not do well on the first round, I feel he should try and keep you at full doses, at least the first trimester in Tx, he should be more aggressive in trying to give you a better chance at SVR this time. There have been people who became svr on reduced doses, but they are not the majority and I believe they were tx naive. I wouild insist on customized tx, If you can.

[honey1616]

I agree with Cuteus.  Those numbers aren't bad at all and many on tx go way lower so your dr needs to be a little more aggressive so you can do this only one round.  Glad to hear you are handling sides pretty well. I know for awhile,,it was really rough.

[whoaisme]

Hi Glad to hear your are managing fairly well. As you know my husband is on week 40 (phew!) of daily infergen and riba. He is on the Intermune study and they do not allow for "blood growth products" (procrit and neupogen)therefore his only option was a dose reduction when needed. Typically his levels rose within two weeks...are you in a clinical trial? If not, try to talk your doctor into the drugs you need without dose reductions. White blood cells assist in your immunity defenses. With lower levels you become susceptible to infections, and slower healing...red blood cells are important for carrying oxygen through your blood, serious drops can cause cardiac complications, as well as the less threatening anemia (which adds to shortness of breath.) Of course there are many other components to our blood, netrophils and platelets for example....and they should all be monitored while on treatment.... anyway I wish you luck and glad to hear you are hanging in there.

[Lynne5477]

I was a 1b and did 48 wks tx......still SVR at 6-mo post.
Anyway, my WBC hung around 2.1 the entire time; dropped to 1.6 once but my doc said chemo patients go even lower so she wasn't too concerned.  Never reduced my dosage due to low WBC.

My Hgb hung around 10.1 most of the time and dropped once to 9.1 (at that time my doc wanted to reduce my RIBA by 1 pill).  Instead I did bloodwork with my PCP and my Hgb was back to 10.1 so I never did reduce dosage.

Try to stay on full dosage as much as you can.  Arm yourself with lots of info to take to your dr so you can keep him as informed as you are.

Good luck on your tx.

[Mariacaro]

RBC's and WBC's is not enough...
They have to check Hgb (indicator of anemia) and Absolute neutrophils (part of the WBC's).
Usually, when the Hgb drops more than 2 g/dL in less than 4 weeks and your Absolute neutrophils less than 0.75 per safety, the dose has to be reduced.
The Dr. is the one that decides if he puts you on Procrit or Neupogen.
I agree that the SVR is not the same, but it depends of what the Dr. thinks, and the most important thing: pt's safety. The management of the anemia and the neutropenia (low netrophils) is the same in the regular Peg+Riba and daily infergen.