Platelets have skyrocketed!!

Went for labs today:  WBC 1.6, HGB 9. 2,anc .5, platelets 134!!!  One week ago my platelts were 55!   I have been as low as 40, but have not been this high since my second week of treatment, and I am now in my 23 week.  Has anyone had this experience with platelets?

Jean

[lalapple]

wow to tell you the truth, i'm quite jealous!  mine's been double digit since 4th wk

[jt57]

Don't get me wrong,  I am ecstatic, but the news is so good, I'm not sure if it is legit.  From 55 to 134 in one week?  How is that possible?

Jean

[jt57]

anyone experienced this?

[merryBe]

well something sure kicked them in, either that or you may be getting less riba absorption. Hows your diet been? At holidays we tend to eat a lot different, Eveb christmas parties with lots of roughage can effect how much riba makes it to the bloodstream.... and this could lead to less riba ergo let platelet damage.
Anyway, be glad it's not so low, but be careful not to eat roughage at or near riba times
as it can really reduce what you absorb.

mb

[Trinity4]

If I'm not mistaken, it's the interferon that effects the platelet production the most, not the riba.  Low platelet count is usually followed by peg dose reduction when it becomes severe.  In my 7th & 8th weeks dose reduction was due to low platelets and ANC. Please correct me if I'm wrong but that is what I've read and that is what others have stated.  Hgb is effected by the riba, ergo anemia.
Trinity  

[jt57]

good point, merryBe.  My diet has been different.  I haven't been eating much, actually.  I need to keep an eye on that.  While I am happy they are up, I just feel that it is really a delusional number, because it just went too high, too quickly.  The highest my platelets have been were 121, my 2nd week of treatment.  So this was really weird.  I will get retested on Monday and see what my numbers are.  Thanks!

No, there have been no Christmas parties for me....no energy, and wbc and anc, too low to be around alot of people.  but I hope you enjoyed many parties!

Jean

[jt57]

You know, I think you are right.  When I was so low, my drs were pulling the interferon, not the riba.

any ideas on why the jump in one week?

Jean

[geterdone]

I think jt57 is stating that her platelets were at 55 one week ago and then shot back up to 134 which is good but she is confused about the jump.

jasper

[jt57]

you got it.  I am really happy, but not certain that I should be.

[geterdone]

Could be the spleen acting up or there is some major virion butt kicking going on in that there liver.

jasper

[jt57]

what could be going on with the spleen?  Could it mean that my liver is not as inflammed?

Jean

[Trinity4]

Jean,
Mine have been all over the place.  Lately, they are hanging around 80.  I eat normal amounts of meat and veggies.  Over a period of time the interferon effects the production of bone marrow and it's a cumulative process.  Our bodies response to the interferon varies from week to week.  Earlier in tx my ANC and platelets would jump considerably every couple of weeks.  After about week 30 they went down and haven't come back up much.  I'm fortunate though because I've never had a problem with anemia and I'm 114 lbs and take a 1000 mg of riba a day.  But I have noticed different platelets counts on every blood test.  Some good, some bad.  I'm on Neupogen for the duration of tx because my body just can't keep the whites high enough anymore.  We just never know from week to week I guess.  Hope your platelets say up -  one less thing to worry about!
Trin

[jt57]

thanks Trinity! I'll check again on Monday.  Keep your fingers crossed that all is well!!

Jean

[merryBe]

you may be right Trinity...I'm half adled tonight thanks to dosing my riba too close together today.  I think they both fry the marrow somewhat though....know somewhere I read that.  Hard to say when my brain is being fried as we speak...

here's something interesting on the topic though...new hope to keep treaters with low platelets from getting kicked out of tx:

Drug Boosts Platelets in Hepatitis C Patients

DURHAM, N.C. -- November 28, 2007 -- It's not a cure, but this may be some of the best news patients infected with the hepatitis C virus (HCV) have heard in a long time: A new drug, eltrombopag, appears to be effective in boosting low platelet counts, one of the major reasons why patients can't endure antiviral treatments.

Other drugs that can restore normal platelet functions are infusions or injections; eltrombopag is a pill taken just once a day.


Researchers at Duke University Medical Center and other centers world-wide studied eltrombopag (marketed as Promacta in the U.S. and Revolade in Europe by GlaxoSmithKline) in 74 patients with low platelet counts and cirrhosis of the liver due to HCV infection. They found that it boosted platelet counts in a majority of patients at each of three dosage levels, enabling most of them to continue or start conventional antiviral treatment.


The findings appear in the current issue of the New England Journal of Medicine.


"We feel this is an important development for many people infected with the hepatitis C virus world-wide," says Dr. John McHutchison, professor of medicine and associate director of the Duke Clinical Research Institute. "A significant number of patients with HCV infection will at some point develop platelet problems that will compromise their getting the best treatments we have. Anything we can do to prevent that from happening would improve their care."


It's estimated that 4 million people in the U.S. and 170 million world-wide carry the hepatitis C virus. The virus causes inflammation and scarring in the liver, and while it is curable in about half of those who have it, it can lead to significant liver damage, liver cancer and death in others. HCV infection is a common cause of cirrhosis and the most common reason for a liver transplant.


Platelets are cells made in the bone marrow that are important in clot formation, and serious bleeding can occur if platelet levels fall too low. Some diseases, like HCV infection, can cripple the body's ability to manufacture platelets, but so can some medical treatments. Cancer patients, for example, can experience plummeting platelet levels when undergoing chemotherapy.


In the phase II, multi-center trial, participants were randomized to a control group or to receive 30, 50, or 75 milligrams of eltrombopag daily. The patients had platelet levels ranging from 20,000 to 70,000 (145,000 to 450,000 is normal).


A phase II trial is designed to test the safety and efficacy of a drug at different doses, and the Duke study found that eltrombopag worked in a dose-dependent manner, meaning that patients got a better response with increasing amounts of the drug. Seventy-four percent of those in the trial who took the lowest dose saw their platelet counts go up significantly, while 79 percent and 95 percent of the participants saw increases with the higher doses.


Eltrombopag does cause side effects. Some of the patients complained of headaches, dry mouth, abdominal pain and nausea.


"We are encouraged by these results and are already working on another multi-center, international, phase III trial where we hope these results will be confirmed," says McHutchison.


The study was sponsored by GlaxoSmithKline, which manufactures eltrombopag. McHutchison and many of the coauthors also report having received grants, consulting, advisory or speaking fees from the company.



SOURCE: Duke University Medical Center

[geterdone]

I think it may be a little of both, as in treatment, both work together in hammering the virions as well as the hemiglobin and other blood cells.

jasper

Interferon has long been known to cause cytopenia, including mild anaemia. With the addition of RBV to IFN therapy, it was noted that the degree of anaemia in combination therapy was much more pronounced than with IFN alone (Fig. 2).[25] In two large randomized trials of IFN and RBV, haemoglobin (Hb) levels dropped by a mean of 2.9 g/dL[25] and 3.1 g/dL[26] with a maximum drop of 7.0 g/dL. The lowest point of Hb levels occurred within 4 weeks. The Hb concentration dropped below 10 g/dL in 7%[25] and 8%[26] of patients, at which time the RBV dose was decreased from 1000-1200 mg/day (weight cut-off 75 kg) to 600 mg/day.

RBV, dose reductions became the SOC for managing anaemia during HCV therapy.

[jt57]

what do you think?  You are always a wealth of knowledge!!
Jean

[Myown]

Mine were high the lab before this last one. But it said that due to "clumping" the results weren't accurate or something like that. I've clumped before and they weren't able to get a reading at all, but this time they did and it was high. The next lab was back down to where its been lately - which off the top of my head, I don't remember what that is right now.

Also in Rockerforlifes blood lab thread it mentions Platelets and reasons they can go high - dehydration is one reason and something about bone marrow stimulation for the second reason. But if you open his thread you can read exactly what they say about Platelets.

Good luck.

[jt57]

Thanks!

[jt57]

I don't think I was dehydrated, or all my numbers would have been higher, such as my hgb  and wbc.  I have had that happen before.  I just feel this is really something weird.  Guess I'll find out tomorrow!

Jean

[jt57]

Looks like I was clumping!  We retested and my platelets are 40.  Ouch.  My hep dr. will be calling tomorrow.  He will either say, reduce, or stop.  Not sure which.  But I won't do either until I retest on Friday and see where I am.  I am not due to take my interferon again until next Monday.  I had taken it a couple of hours before I had my blood drawn this morning.  Maybe that is one reason they were so low.  My wbc was lower as well, 1.2.  everything else the same.

Jean

[geterdone]

You may want to read the following el.

jasper

A deficiency of ADAMTS13 leads to platelet
clumping and/or thrombi formation, finally resulting
in thrombotic thrombocytopenic purpura
(TTP).


http://www.haematologica.org/cgi/reprint/91/8_Suppl/ECR34.pdf

[nitramog]

does it feel good!  maybe the virus is giving your system a brake and some healing time treatment can have some good affects for awhile our for good  good luck

[jt57]

could not pull that link up

[Kathy73]

I was diagnosed with ITP which is a platelet disorder 4 years ago. My platelets are usually between 40-48. In order to get a biopsy I had to have 5 days of gammaglobulin infusions to bring them high enough. At my 4 week blood test on TX my plateletes were 117 which is the  highest they have been since I've started being tested in 4 years! Now they are 134! I've asked on this forum if anyone else had the high platelets but didn't get much response. I'm on week 9 of tx for hvc and hope the platelets keep it up!

[Myown]

So you're a clumper too..I forgot to mention (brain fog) that my doc didn't think much of it and said when the lab lets the blood sit too long it can cause the clumping. So who knows. My next lab Plates weren't high anymore. They were 98. But a few other things were in the high range and I guess it was accurate being I didn't clump. BTW, it is best to try to take your shot AFTER the blood draw, not before. So you are right, maybe that did effect your white count. I would ask your doc.

Take care.

[SteveHepC]

I'm not in treatment, but my Doctor and Lab tell me that elevated Platelet count is one of the first indications of fibrosis. However, the acceptable range is 140 - 440. Mine is 237 and is down from 275. I'm real happy with that. Other early indicators of fibrosis is Total Protein and Albumin. Low is bad on these markers and mine are at the high end of the scale.
I'm 70 years old with a viral load of 2,300,000 that also stays steady. I wouldn't go through treatment again for any reason. That Riba and Interferon is way worse than my Hep C. I'm 2b with no symptoms, normal ALT and AST, have no clue what my stage is cause I'm not a candidate for a biopsy. I don't think I want to know. All I do know is that the current treatment tore me up, and made me a depressed, fatigued, worthless person whose hair was falling out, white and red cell counts crashed. I was negative at 12 weeks, then relapsed with a viral load of 103,000 at 24 weeks.

[geterdone]

You’ll have to copy and past into the web browser to get to the Pdf file.
jasper

[jt57]

thanks all!  I have been tested for TTP, and it was negative.  Coming up on week 24 and so afraid I may have to stop treatment, but then again, treatment is really sucking!!!!  But I am und, and have been since about wk 9 or 10.  They will check my viral load again on the 6th.  I pray I am still und.

Thanks all for your responses!

Jean

[merryBe]

I think the operative thing is not to get to excited or worried about any one lab test.
If the people in here have learned anything we've learned that.

If you were getting sticky platelets they might put you on blood thinners. The platelet abnormality is quite common...and sometimes they even call it leukemia which scares folks to death..but it is not a true leukemia...its just misshapen platelets that people can live long lives with.

but before you get excited retest.  All the bad weather has had people not showing up to work. Your lab may be behind, your blood may have had time to clump...heck it's not just the mail that's been goofed up by weeks of snow.

so just keep in mind there may be nothing wrong with your blood..just the way it was handled.  
And if the 40 on the retest was accurate, well some docs don't worry with us treaters until it goes to 20....but I'd still start to explore with him the idea of neupo, or that other drug i POSTED about above.

mb