16 wks results

[mirceani]

My CBC at 16 wks came back (viral count still pending)

WBC  3.6
RBC   3.85
Hemoglobin 12.6
Hematocrit:  37.1

The PA called and said not to worry, the numbers are low, but not extremelly low.
She said I do not need procrit yet, and advised to keep going with my treatment.
She does not want to go from 6 Riba pills to 5 pills
I do feel weaker lately, which is sure related with those numbers.


So anybody has any advice?
Is this normal?
Should I expect those numbers to continue this decrease?


Thank you

[jmjm530]

Hemoglobin drops tend to hit men harder, especially as we get older. The absolute number is often not as important as the drop from pre-tx baseline and/or rate of drop. This may in part be making you feel weaker.

As FLGuy suggests, hopefully your hgb decline will taper off and also the body tends to adjust to lower levels of hemoglobin, similar to when you acclimize in the mountains on let's say a ski vacation, probably not the ideal vacation destination while on treatment :)

Still, if you're starting to feel weak, and your pre-treatment hemoglobin was several points above -- it's a good idea to keep an eye on hemoglobin, perhaps with more frequent testing. You may not need Procrit yet -- you may never need Procrit -- but good to keep it in mind and have that discussion with your doctor as Procrit takes 2-4 weeks to kick in. If and when that time comes, you will probably want Procrit over a reduction in your ribavirin.

As to "WBC" it looks fine, but the WBC fraction my treatment team was concerned about was ANC (absolute neuts). I'm sure yours are fine with your given WBC, but always good to keep an eye on them

-- Jim

[mirceani]

Thank you for your kind advise.
All the other numbers in my cCBC are in normal range, so I did not include them in my post

[FlGuy]

Most docs will not be too concerned with hgb until it goes below 12.  Even then, they may just watch it.  Since you are in week 17 you should not expect a precipitous drop, more likely a gradual decline.  Avoiding dose reduction is important.  When you next speak with the doc, assuming hgb continues down, you might inquire what the plan is and at what level he will take action (procrit or other).  I had cooked a deal with docs to maintain it between 11 and 12 with the first Aranesp (sorta like procrit) at 11.2.  That was an insurance-friendly level for me and it was important for me to give the semblance of a life form for work purposes.  Although you mention wbc, do you see a separate reading for neutrophils or absolute neutrophils or ANCs?  That's another level the doc should be watching for possible remediation with Neupogen.  Hang in there!

[mirceani]

any feedback?

thanks