low wbc

Hello everyone.  I hope you all are doing well. My last blood test my wbc was 2.7  .  My doctor ran another cbc yesterday. To see if it has risen or fallen any . My hgb is holding steady at 12.6 .  My question is with a low wbc should my doctor consider putting me on a rescue drug ?

[jmjm530]

Most doctors base rescue drug decisions not on WBC but on the WBC fraction called The Absolute Neutrophil Count, otherwise known as "ANC".

Some doctors intervene with Neupogen as early as ANC 1000. Others at ANC 750 or ANC 500. My hepatologist, as well as some others here, don't consider intervention until ANC approaches 300. That's in part because newer studies show no relationship between Interferon-induced WBC and infections.

Now is as good as time as ever to ask your doctor about their rescue drug policies both in regards to WBC/ANC as well as with hgb.

Be well.

-- Jim

[jmjm530]

Second paragraph should read in part:

That's in part because newer studies show no relationship between Interferon-induced *low* WBC and infection rates.

[hepcD]

Thanks Jim i now have a better understand of the issue. I will call Doctor monday and discuss  his policy of rescue drugs .

[dyce]

Hep, as jim stated most docs don't start 1 on wblood boosters til the anc drops to 750 and lower.

  My vampire doc(hematologist) didn't start me til the anc went down to 700. He explained that since flu and cold season is here, it wouldn't hurt to start the neupogen but I didn't have to start it til the 33rd week of tx. Good luck!!!

  Jim, since starting the procrit at week 26 and being on it at around the 5th week , my appetite came back . I've raised my weight up to 175# at this point. My low was 158 #, a 60# drop from my regular weight. Been eating alot better but when I finish tx , it will be back to exercising and eatin good steaks and tators!!

  How is your back jim?? Have you been able to resolve the problem??

[sfbaygirl]

My ANC went down to .9 Wednesday and I have been avoiding the hemotologist ever since. I am hoping to get another CBC Mon. or Tues. and see if it goes up on its own. It has been going up a couple of points a week. I was at 1.5 ANC.

I was wondering where to find that study again that you posted before. I can't find it in my files. So it is the interferon that is why we don't get the infections? I am now ready to pay the $15 and send it to my dr. You know how I hate those Neulasta shots!

How are you doing? How is the skin? Better I hope! The weather is fabulous here. I love this time of year outside. Everything is so warm and clear.

[jmjm530]

I think this is the study but if not something similar:
http://tinyurl.com/v7kjj  If I find another similar study I'll post later. As I mentioned previously, my medical team rarely intervenes with Neupogen in their practice and they see tons of Hep C patients. One week my ANC was 320 and two weeks later it was over 1000, without Neupogen. On the other hand I did have a lot of infections but according to the paper they were probably not related to my WBC/ANC.

Skin is almost back to normal and hopefully it will stay that way when the winter cold and next summers sun/heat hit. Back still bothering me and I'm starting a stretching/strengthing program. I think running stadium steps might have caused the spasms, maybe that combined with a lot of inactivity during tx. Thinking about running some today which is probably a bad idea but that's never stopped me before :)  Thanks for asking guys.

Dyce, that's wonderful your weight is up and appetitite has improved. These are the kind of things that make it easier to continue on. Just keep saying your mantra -- Steak, Tators; Steak , Tators; Steak, Tators....

Wish both of you all the best getting through treatment.

Be well,

-- Jim

[sfbaygirl]

That is great your skin is better, I know how you suffered. Going out on stadium steps? My back hurts just thinking about it! I had a back problem last week along with stomach pain. That was really special. I thought someone stuck a pole through me! It's all better now, but exercise is the best thing for bad backs. I have some good back exercises, when I can do them.

I have been feeling fairly good, and got on the exercise bike for the second time today. I did 12 minutes! I can't believe it myself. From not being able to walk to it, to going that much is a huge inprovement.

Now I am going to put a message on the answering machine for the Hemo to tell him I am out of town until my ANC goes above 1000. LOL

[Better_Angels]

Please try shark liver oil. My husband had low WBC's during his first treatment and started out on Neulasta and then Neupogen. Both of those drugs made him feel like he'd been run over by a truck. When we discovered he relapsed I started searching for something to help keep his WBC's elevated during treatment. I found an article by an oncologist who said that he put his patients on Northern Atlantic Shark Liver oil. I couldn't locate anything with that name but I found Scandanavian Shark Liver oil and I immediately purchased it and started my husband on it. During his second treatment he never required the rescue drugs for WBC's but did still have to take Procrit for his RBC's.

I know it worked because he stopped taking it for 2 weeks when the gel capsules melted and subsequently his WBC's dropped. When he started taking it again they rose back up. He was never normal, but he never fell low enough to warrant any rescue drug.

Here is the link to where I purchased it. I gave him the maximun dosage. http://www.iherb.com/store/ProductDetails.aspx?c=Herbs&pid=SCA-00024

It's worth a shot, it's better than the alternative. If it doesn't work for you then you can always start up with the rescue drug.

Good luck and kind regards,
Debbe