Low White Blood Court

[Deb9991]

My clinic finally called me and told me that the reason I have to skip my IFN injection for just this week was because my WBC was getting low.  I asked if this was going to effect my UND status, and they told me "absolutely not."  My WBC was 4.0 out of a normal range of 3.6 - 10.6.  So, it is getting a bit on the low side, obviously.  I was also told that skipping one dose would probably bring it up.  I've heard so many things, that I just don't know what to think.

What if skipping a dose does not bring it up?  I guess I'll have to go on another medication to bring it up?  I've heard a lot about low HGM and platelets, but not much about WBC.  

I also called a nurse at Roche over the weekend, and she made a bet with me that it was because my medical providers were concerned about my WBC -- she was right.  

Any info about my low WBC at this point would be appreciated.

Thanks,

[can-do-man]

Flguy.........."Your doc is an idiot"

Plus........."The answer is Neupogen and NO dose reduction."

Best answer i have seen here

cando.

[Deb9991]

You are right -- no one can say "absolutely not."  First it is practicing poor medicine and we all know that there are no absolutes until you've tested UND six months after treatment, and even then, there is a chance this virus could come back -- it has happened.  

I don't know why they said that -- I was arguing the point, and maybe that was annoying to the person I talked to.  Because I kept hitting this clinic about everything I had read and studied about skipping a dose -- I've also heard, as mentioned somewhere on this post, that one missed dose probably won't have an impact, but others say it can.  The point of the matter is I just will never know, especially if I don't achieve SVR -- and it is no guarantee whatsoever, especially with G-3s.  They have a funny way of being UND for a long time, right up to the end, and bingo, that virus can come back, but it can for anyone.  

I think the real important thing to remember is that it is probably wise and prudent not to get your hopes up to high while treating.  Keep focued and do everything to the best of yur ability and also keep in mind that this treatment may not be successful -- that is what I am doing.  I'm just looking at treatment as a possible chance -- and no more.  

Thanks for all your support today.

Debbie

[Deb9991]

I don't have a history of any autoimmune disorders.  I did test positive for cryoglobulins in the blood, but I'm not sure about that.  This disorder does fall into the rhematoid artritis family, which, I believe, may be considered an autoimmune disorder.  Finding info on cryoblobulins is no easy tast.  First it is rare and I've read conflicint account about it.  One study said that "mixed cryo" is definitely an extrahepatic manifestation of HCV, and that it is fairly common in people who have this virus.  Another study said it isn't all that common in HCV patients.  After treatment, I'll deal it then.  Actually, because of cryoglobulins in my blood, I decided to treat.  I may not have.  There is no liver damage -- 0 fibrosis.  Supposedly treating successfully with IFN, and achieving SVR, can also knock out the cryogloblins, but that isn't guaranteed either.  What a dilemma!  Also, another wrench thrown into this cryo deal is that I did not test postive for RA.  So, I'm not even sure, to be honest with you, that this cryo is caused by HCV.  Maybe I've had it all my life -- I don't know.  Most doctors know little about it.  It is a mystery disease and for the most part is not real serious, but it can in some cases -- it can be real serious, even deadly.

Other than that I've never had a doctor tell me there was anything wrong in that area.  

[Deb9991]

Yep!

My sentiments exactly.

[Marcia2202]

I would just do the shot and not tell the doc about it. :-)

[portann]

CockSparrow was a G-3 who had null response two times and went on to SVR.

He knew a heck of a lot about G-3's (and the related studies) and I wonder what he'd advise about you skipping a dose. I wish I could ask him.

He said, "Whats also clear is that G3s who RVR are dead easy to treat, at least as easy as G2s." I think he based that on the highly complex Berg study.

http://www.medhelp.org/posts/Hepatitis-C/3a-Riba-dosage/show/481276


"Tailored Treatment for Hepatitis C" by Thomas Berg, MD

"It is no longer appropriate to generalize that patients who have HCV genotype 1 and 4 are ‘‘difficult to cure’’ because of viral kinetic evidence to the contrary. Conversely, it is no longer appropriate to think of all patients who have HCV genotype 2 or 3 as ‘‘easy to cure.’’ Although genotype is an important driver of response and is useful in designing the initial treatment plan, it is clear that once treatment is initiated, RVR is the most important and powerful predictor of SVR."

Even though you've got such AMAZING predictors working for you, zero fibrosis, starting viral load of 50,000 (!), undetected after three weeks of meds, maybe earlier, female, I'm stumped why the doc would intervene with those numbers and not give you a study to support his decision or refer you to some sort of published guideline. And why didn't he offer a dose reduction instead of skipping it entirely? :(

I hope you keep us posted.

Susan