Low WBC, RBC & Platelet, should I continue treatment?

[kally291]

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.

Really appreciate your reply.

[kally291]

hahaaa~ No problem. Feel happy to share with you.

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.

[Idyllic]

Yes this disease can be very time consuming with the lab visits and doctor appointments and the three times a day you take the Incivek (as well as the doses of Riba). It helps to be organized.

It is a good idea to ask the doctor how low certain values on your CBC can drop and what will he do when they do.


For your WBC the value that it helps to know is the one called Absolute Neutrophils. It might say Neutrophils (Absolute) abbreviated as ANC. That number is used as a gauge rather than the WBC.

So (basically) your Hgb, ANC and platelets are the values to keep an eye on.

[ppmguy]

              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

                                   barry

[kally291]

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.

[Idyllic]

I agree with all that has been said. I would just keep having the lab tests when you are scheduled and be sure your viral load draws are scheduled on the right dates.

I am glad you are feeling well.

[Idyllic]

You are in week four and you are UND that is fantastic news :)
On the other hand

Errr...wait a minute just to be clear you started treatment 29 March and you say "I took my lab test this Wednesday."
That means
Friday, March 29, 2013
To and including: Wednesday, April 17, 2013

is 20 days.

3/29 week - 4/5   week 1
4/12 week 2
4/19 week 3
4/26 week 4
___________________________

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.