just got call from nurse

[jonney4141]

she said my wbc were low, and wanted me to reduce shot from 180 to 90, and have blood work done tomorrow. i am geno 1 stage 1. does anyone know what this could mean? thanks
jonney4141
also only on week 5 of 48

[Bill1954]

Jonney, the drug Neupogen is available to combat low white cell count; do you know why this wasn’t considered? It works rapidly, and doesn’t compromise your treatment by keeping you on full dose interferon. The white cell count is actually determined by ‘Absolute Neutrofil Count (ANC); do you know what your current level is?

Bill

[jmjm530]

The important number here is called absolute neutrophils or "ANC". It is the WBC fraction that doctors look at. Do you know your ANC? If not, ask your doctor and also make sure you get your own copies of all blood tests.

Most experienced liver specialists will not require a dose reduction unless ANC is 500 or less. Unfortunately, some less experienced doctors might. Is your doctor a liver specialist (hepatologist) or a gastro? Gastro's often reduce medications without cause.

If your ANC is above 500, I would ask to speak to the doctor and question his advice. Personally, if he would not let me continue on full dose I would seek out a consult with a hepatologist.

If your ANC is below 500, I would then ask for the helper drug Neupogen. Taking Neupogen is preferable to reducing your dose of interferon. Reducing your dose of interferon so early in treatment can harm your chances of being cured.

-- Jim

[nygirl7]

Unfortunately, some less experienced doctors might.

Exactly, please make sure you find out just what the number is.  the ANC can bounce around and go back up all on it's own - that is what happened with me and I was glad my doc did NOT dose reduce.

Dose reduction should be the last last resort that you take because it CAN affect your chance of achieving SVR. Especially in only week 5 - really.  Ask for the ANC and then ask for Neupogen.  IF you should develop a problem with the hemolytic anemia as well you ask for Procrit.  These are the two helper "rescue" meds we use so we do not have to dose reduce and they both are very good at fixing the problems (although the Procrit takes longer to work so you want to stay on top of that number).

This is why we ALWAYS advise you get a hard copy of every single test you have taken...you can learn to read them easily enough by pasting them in here - often times you will find yourself much more on top of the doctor than he is.  after all, you care more about yourself than he does!

[AKHepper]

I can't believe they are still reducing doses. They did it to me 5 years ago; 1 month in reduced me to 3/4 dose. I did 52 weeks and relapsed 4 months later.
If they are going to reduce your dose, you might as well quit altogether, IMO.

Tell your Dr. you want Neupogen.