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How low can WBC count go before you treat it?
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How low can WBC count go before you treat it?

Week 8 results just came back with WBC count for my husband at 2.8, is that low enough that it should be treated? He doesnt follow up with the doctor for another week, so I guess we'll find out then, but i thought maybe some of you would know the answer before that.
thanks & Happy Valentines Day everyone :)
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11 Comments Post a Comment
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1747881_tn?1358189534
Mine has been down as low as 2.4 without intervention but my ANC has stayed at the very low end of normal range through out tx.(in wk 25 of 48)
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163305_tn?1333672171
My hepatologis goes by anc not by wbc. If my anc is .5 or below, I take neupogen.
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Avatar_m_tn
The WBC is made up of various cells of which the ANC(absolute neutrophils count )is the main  one in regards to fighting  infection.

As hersp and OH mention this is the one most doctors watch and there are differing opinions in the medical community  on how to intervene if they get very low.

Some Hepatologists will start Neupogen at approx. .5 or .6 and some will let it fall even further before they become concerned.

There are others that will start a prophylactic antibiotic instead.

Best to discuss this ahead of time with your doctor..
Good luck..
Will
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Avatar_m_tn
Mine also goes my your ANC, he doesn't get to concerned about it unless it gets to .3 or lower, and even then he really didn't think to much about it... Mine seemed to jump around alot on treatment
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Avatar_f_tn
At 2 weeks my WBC fell from 5.6 to 2.5

My absolute Neutrophils (ANC) fell from 3.2 to 0.7

My doctor said that these counts looked stable, and to just continue my treatment as I have...and this was confirmed by the people in the know here.

My doctor told me she watches the ANC more closely then the WBC, and if ANC falls to .5 or below we will review the need for a rescue drug at that time.  This also was confirmed by many here as the time to consider rescue drugs.

I take another blood test this Friday, so we will see where I am at at that time.
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1986676_tn?1329866071
It's the ANC or neutrophil count that doctors really look at...
That's part of the WBC. My doctor however never let my neutrophil count get as low as 0.5.
                
Personally, I would be concerned if I took another injection of interferon with my ANC at 0.5.

Maybe someone with more knowledge of ANC will chime in. I have a normally low ANC without tx so I have to watch it really carefully.

Reva
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1669790_tn?1333666195
I do my interferon shot on Friday evening and have my cbc's run on Monday afternoon.  They are consistantly at 0.2-0.3, so do the neupogen shot.  On Thursday I had a second cbc run and the ANC would be at 0.7 or higher.  Since I was seeing a hematologist that is affiliated with a cancer trt center, his threshold for neupogen was for an ANC at 1.0 or lower.  

My point is, it really depends on what day you do the Inf shot and what day you have the cbc run.  For me, the interferon hammers my wbc/anc and it goes very low 3-4 days later and rebounds later during the week, just in time for the next shot.

After reading many publications which clearly show no correlation between the ANC and risk of infection for HCV patients, I discussed stopping the Thursday nuep shot with my hemo and finally down to one per week.  With cancer trt there is a high risk of infection with a low ANC and wbc, so I believe this threshold of trt has been transferred to HCV patients, at least in my personal experience.

Although a low WBC goes hand in hand with a low ANC, as others mentioned the docs pay closer attention to the ANC.  It is actually a complicated calculation beyond my explanation that you can google to read more about if interested.  
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Avatar_f_tn
My husband's WBC was 2.7 at his last CBC, and his NP said all counts were stable. He hasn't had any problems.
Advocate1955
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1118724_tn?1357014191
I believe the official cutoff for low WBC is 1.5. ANC can be derived from numbers on your CBC.
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Avatar_f_tn
My husband's WBC was 2.8 at last draw.  Doctor said that was stable and just fine.
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1986676_tn?1329866071
The WBC is different  from the ANC count which is a part of the WBC.
You may have a 2.4 WBC and have an even lower ANC count.
What I think  most doctors look at is the ANC count. Absolute Neutrophil
Count.

If another could comment please help us out with with this one.
My understanding of this might be a little off and I want to be sure of this...
Reva
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