Question regarding lab results

Hi folks!
OK, I have a question. I am probably going to be starting on Procrit soon. My Hg. actually came up a little bit this week. I'm back up to 9.8. I was on vacation so I felt pretty good all week. Today I repeated an Iron profile and a Ferritin level. The Iron profile was normal. My Iron was elevated before I started treatment back in Feb. My Ferritin level is now up to 430, normal being 23-307. That was normal before I started treatment. Anyone know how the meds and just the disease process affects these levels and what it means? I know my spleen is enlarged but I figure it's working overtime trying to get my blood counts back to normal levels. My WBC actually dropped back to 1.2 and this is with me on Neupogen. The PA thinks maybe it's just because normally I draw my blood work on Fridays and so I've gone three extra days. I'm due to take the Neupogen today. So I'm going to repeat the CBC this Friday. Anyway, was just wondering if anyone has any input about this. Thanks.

[CoWriter]

"I know my spleen is enlarged but I figure it's working overtime trying to get my blood counts back to normal levels."

That is NOT TRUE.  The spleen does NOT get enlarged for that reason.  If your spleen was NOT enlarged before you started treatment, the fact that it is enlarged now would be worrisone.  I'm not sure using Neupogen on somebody who has an enlarged spleen is safe since Neupogen can cause the spleen to rupture.  I think it's important that you discuss that with your doctor.  

This is what the medication insert says about it.....


"SPLENIC RUPTURE

SPLENIC RUPTURE, INCLUDING FATAL CASES, HAS BEEN REPORTED FOLLOWING THE ADMINISTRATION OF NEUPOGEN. INDIVIDUALS RECEIVING NEUPOGEN WHO REPORT LEFT UPPER ABDOMINAL AND/OR SHOULDER TIP PAIN SHOULD BE EVALUATED FOR AN ENLARGED SPLEEN OR SPLENIC RUPTURE."

http://www.neupogen.com/pi.html#warnings



" My WBC actually dropped back to 1.2 and this is with me on Neupogen."

It doesn't matter how low the white cells are, it is the NEUTROPHIL count that you're supposed to be looking at.


"The PA thinks maybe it's just because normally I draw my blood work on Fridays and so I've gone three extra days"


Your blood test should be done shortly BEFORE you take the Peg injection rather than after.  That's what hepatologists recommend.

This info comes from a side effect management booklet written by some of the top hepatologists.  Here's what they recommend......


"Lower neutrophil counts will be recorded if the blood for the CBC is drawn within 24 to 72 hours of peginterferon administration. Consider drawing the CBC 1 to 2 days
BEFORE peginterferon administration."

(Page 87)
http://www.projectsinknowledge.com/Init/G/1628/1628-Handbook.pdf

[wed1942]

Wow, thanks for the info. I do remember reading about the possibility of rupturing your spleen while on one of the meds. Couldn't remember which one. I need to check through my papers to see if my spleen was enlarged prior to treatment.

I usually do my blood work the day before I take the next Pegasys injection. Was just off this time cause I had been out of town. Will repeat this on Friday to see what it is.

I'll get the lab work done Friday and then might put a call in to my doc to see what he actually says about the enlarged spleen, etc. Thanks for all of the advice. This still gets overwhelming at times. I'm into my 31st week now. They want me to go 72. Wish I could just wake up tomorrow and it would be done.

[jmjm530]

Many of us with HCV have enlarged spleens entering tx so that in itself should not be reason for concern. How enlarged -- not stated-- may be a different story. And yes, viral load blood shld be drawn the day before tx or day of tx but before the Peg injection. Other blood work can be done any time.

[CoWriter]

"Other blood work can be done any time. "

Pleaser check the link I gave.  That was written by Mc Hutchinson and the other top hepatologists.