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After 4 weeks on the treatment, blood test results are "normal" as per my doctor.
I am not anemic (normal RBC), but the white blood cells count is low (3.3)
Before the treatment it was over 6.
Should I be concerned?
Select the test 'CBC'. There are several pages of information dealing with what is evaluated int the CBC. This is probably what your doc runs to evaulate your blood work. You will see, as it applies to WBC, that there are seveal components in WBC. Similarly, in the vein of RBC, the doc may be a little more interested in hemoglobin and platelets rather than just "RBC". Interesting reading since it's going to be part of your life for a while
There are different views on what's considered a low WBC. I would think that if your Dr. was concerned he would contact you about it.
From what I understand, some physicians don't treat low WBC until they're less than 1. My WBC also dropped in the first 4 weeks to less than 75% of their original level, down to 1.3 from a pre-TX count of close to 6. My Dr. put me on neupogen, which I have taken twice a month for the past 11 months. WBC never bouced back to normal but at least it's not lower than 1. Now it hovers around 2 - 2.5.
Becuase of the low WBC and ANC I now have neutropenia and leukopenia and apparently ithat can cause a susceptibility to infection.
Sounds like your levels have dropped 50% but 3.3, from what I understand, isn't considered too bad.
Some studies say low WBC don't need to be treated until .5.
I think some drop is considered normal mainly because you begin treatment, and before beginning your body was fighting the infection all on it's own, suddenly it has a big boost and usually a commensurate drop in viral load. some people drop 2 logs in a week!!
however fast of slow you drop, (mine dropped 2/3 in the first month) that means your own bone marrow doesn't have to work quite so hard at fighting a virus it's fought on it's own for a long time. So it will slow down, take a break, from making so many white cells for a bit. It usually will return to more normal levels after tx.
the main thing to watch is your platelet and iron levels, also, I believe it's the basols that go up in cancer.
In any event, a good doc will keep a close eye on all those numbers. Make sure you get a monthly test though, (I read where someones doc waited 12 weeks to retest)...it's very important to head off any really dangerous changes quickly, while they can be remedied.
your white blood cells deal mostly with infections/cancer/toxins, not nourishment or oxygen like the red ones,....a good liver guy will keep track of your t-cells and all that good junk.
one thing I do, is have the lab mail me the results from every test. If anything looks out of normal range (normal range is printed on the sheet right next to your results), then get on the phone and find out why this is so, and whether anything should be done.
the docs and staff will tend to keep a better eye on your labs if they know you also are monitoring their analysis.
Low WBC is normal on treatment. My doc, like many, don't actually focus on WBC, but on the WBC fraction called ANC (absolute neutrophils). WBC and ANC values considered normal on treatment are different from values considered normal off treatment. A good liver specialist should know what is within range, so that's probably why your doc says your value is "normal".
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