Low WBC, RBC & Platelet, should I continue treatment?
I was detected hep C last summer, seems I was infected by blood transmission when I was 3. I'm 23 and started my triple therapy Mar 29. So today is the first day of my 4th week treatment. Feel good during the treatment, less side effect. Only feel losing appetite and hard to finish 20g fat. I took my lab test this Wednesday.
I got the result today, it shows
HCV RNA, PCR Quant not detec,
HCV Viral LOG not detec.
But the WBC, RBC and platelet are abnormal, especially for my WBC.
WBC 2.1L 4.0-11.0K/UL
RBC 3.67L 3.80-5.10 M/UL
HEMOGLOBIN 10.8L 11.5-15.5 G/DL
HEMATOCRIT 33.4L 34.0~45.0%
PLATELET COUNT 99L 130-400 K/UL
Should I continue the pegasys injection tonight? I already contacted my nurse, but the phone call turned to voice mail. I read some articles, seems when having a low WBC you need stop the treatment. I'm just shock when I seen this, because I feel everything go through better than I thought before I start my treatment.
Sorry for my poor English, I hope I express everything clearly and offer enough information.
Should I continue the pegasys injection tonight?
Everything your blood labs show is perfectely normal for someone undergoing HCV therapy and nothing there shows anything of immediate concern
The WBC and HGB ..is usually somewhat less than normal for someone doing tx,however yours actually look very good
The plats at 99 are somewhat low and would be monitored by a good treating physician ,however again..not anywhere near the level of immediate concern ( lower than 50 many doctors would take action ,however many have been know to continue tx. as low as in the 20's)
Thank you!!! I was terrified by my mom, she keep mentioned a long list of food that can improve WBC. But when I ask my dr, he said he would not recommend bc the Incivek may have conflict with these food.
hi kally, i think you are doing very good on your therapy. your tx dr can lower your peg dose to 135 mcg if your wbc falls to 1.6... if your hemo falls below 10 your dr has options there also. when my platelets fell below 75, my dr said "dont fall down". yes, always let your dr know. your rvr is reason to stay on tx.
I think I probably worried to much. Bc I feel a little bit sleepy when I step in the 3rd week of the treatment. Not like the side effect said insomnia. My dr said it probably bc of anemia. So when I get my lab, it shows abnormal, I was shocked.
You can't do anything about any of those numbers. If they get severe enough your doctor might prescribe "rescue" meds that will help, or might suggest reducing the dosage of your ribavirin, but you are not currently near to those levels. Each doctor does things slightly differently, but to give you a better idea of the problem numbers, most do not worry about platelets unless they go below 50 (and then consider Rx Promacta or transfusion), most do not worry about HGB until it goes below 10, and some let it go as low as 8 before taking action (Rx of procrit injections or possibly transfusions), and most do not worry about low WBC unless the ANC drops below 0.5, and then consider dose reduction, Rx Neupogen injections, or stopping tx.
During tx my HGB dropped as low as 10.1, my ANC dropped as low as 0.6 and my platelets dropped as low as 0.51. My doctor ordered more frequent testing (weekly) each time something dropped near to the cutoff line, but each time the numbers bounced back a little on their own without intervention. I completed 48 weeks of tx in Sept 2012, without any rescue meds or dose reductions, and am now SVR.
You can do it, just make sure you have frequent tests whenever the numbers drop very low, as not everyone has them bounce back on their own!
This is interesting because you are young and presumably in good health (??) and while I would take my shot of Peg I have to say to me at this stage if your dates are accurate these meds are really kicking in.
Can you tell us more about your health and whatever else might matter? I would do my shot as well but I am wondering about your Peg dose and how you are feeling. The reason I ask is because over the next few weeks your values may stablise, gradually drop or plummet.
When I was on Incivek one minute my Hgb was 10.1 and I felt fine and the week after the my Hgb was 8.1.
Thank you for your numbers. These gives more conception about how low I can go. I think I have waste most of my time with my dr. Next time I should ask him how low he think I can go. :) Anyway, I feel good I'm UND and not very severe side effect. The only thing right now is finish the rest 8 weeks quickly and get rid of Incivek. The 20g fat make my stomach feels bad.
i dont recomend dose reduction at 1.6. when i reached that threshold, i was told by tx dr that protocol is dose reduction to 135 and to do cbcs weekly until cbc is stable. i had 2 dose reductions to 135mcg of peg and i am und for 14 weeks post tx. so protocal
I think my health is in good condition. No smoking, drink little before detect hep C, since July 2012, I quit drinking. When I start the treatment feel less side effects. I think sometimes I feel hard to have 20g fat, bc I don't eat that much before I have the treatment. And I don't choose the right fat source. I feel I don't like peanut butter. Right now I'm having soup with 1 and a half tbs olive oil. Olive oil seems good for our health, :) and it can help lose weight. That's my motivation right now. My suggestion is start 20g fat food a little bit earlier than the treatment. Let our stomach have more time to adjust to new food diet. And choose the right fat source.
But when I get my base lab test, the WBC and RBC shows close to the bottom line of the range. So that's why I'm very worried about the WBC.
About my does. I have peg 180mg, Riv 1000mg (600mg am,400mg pm), Incivek 2pills per time, 3 times per day( I believe it's 375,but I'm not sure, I will check after I'm back home)
I guess I'm UND so quick bc my viral loading is low. Bc my dr said my viral loading is low when last time I meet with him. If you are interesting I can share with you late after I'm back home.
WBC 2.1 Neu % = 12.5% Then your ANC would be .26. I am surprised your Dr has not suggested Neupogen just to get all of those levels up. I think I have seen some with that low of range. It doesn't make you feel bad but can be dangerous if you were in a car accident or something major due to internal bleeding. You should talk to him about this. Do your gums bleed or is your urine red?
If it were me...... I would take the shot. I never reduced when my Dr's told me to but that is ME! This is your decision...not mine. If you do take it just take it easy and don't start up the chainsaw or anything like that :)
Just want to correct something that got posted (due to treatment induced brain fog, I am sure). Neutrophils have nothing to do with bleeding. I am sure Jules meant to say platelets when she was referring to the bleeding and infection when she was referring to absolute neutrophils.
When the Absolute Neutrophil Count gets low, there is a possibility of increased risk of infection. That is why the docs keep an eye on the absolute neutrophil count. If your count does get too low, your doctor can order Neupogen.
Your insurance company will always tell you to stop treatment and or go to the hospital for every little thing. I have 1.6 WBC as of 5/10/13 and my doctor told me to hang in there so I am. I can only trust my doctor's advice. The internet is also full of information that can scare the daylights out of anyone on this treatment if you let it. I'm on my 24th week but I need to go 48. Keep the faith.
This last post "The internet is also full of information that can scare the daylights out of anyone...." Is very true. You really need to filter your information. This forum is one if the best places to get info because it is very self-correcting. When someone posts incorrect info, whether from brainfog, typos, or old-fashioned ignorance, it is always corrected by another member within a day or less. After a pretty short time you will learn which posters are always reliable (or which ones think more like you do and thus make the most sensible explanations for you).
I just get my new CBC lab results
This lab is taken by the end of week 6. I'm just feel afraid that I need to take Neupogen later some time. I heard it has side effect as well and need lab test weekly. Have an appointment with my dc this Wednesday, he has no suggestion about my treatment plan last meeting, but I think I can take only 24 weeks bc I was UND at week 3.
Several people on the forum have taken Neupogen and several have taken Procrit so they would know the side effects. Those helper drugs have helped many get through treatment and attain SVR. Hopefully you will also get through treatment and attain SVR. Keep us posted.
If you were UND at week 3 and do not have cirrhosis or were not a null or partial responder in the past, then you will probably do 24 weeks.
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