Your ANC is fine according to most treatment guidelines. Every treating doctor has different thoughts on this, but mine is hesitant to give Neupogen unless the ANC goes down as low as 300. Mine is currently 500. I don't think they have really linked increased infections to lower ANC's.
Especially since you're almost done with treatment, if it were me I'd just leave well enough alone.
I'm in the Vertex study and they use a neutrophil threshold of 750 for IFN dose reduction (or the use of neupogen). But like mark says I've heard experienced hepatologists will commonly allow neutrophil values well below 750, I've even heard as low as 300 is ok if you are otherwise in good health. Also, from my experience neutrophils can go up and down during treatment. Mine were 500 on my last blood work, and they'll probably go back up to closer to a 1000 next time. So don't be surprised if your next value is higher than this one. Unless they're is something "special" or out of the ordinary that would make your low neutrophils a more significant problem than your average/otherwise healthy HCV patient, then I wouldn't worry at all about 850 neuts. Just wash your hands alot and try and stay away from sick people. Also put antibiotic/antiseptic creams on cuts and keep them covered/clean at all times (i.e. you're more prone to infections when your neuts are low).
Otherwise, being so close to the end of treatment, I'd say you're going to make it just fine. Hang in there and here's to your SVR - best of luck.
Do not worry, ANC of 500 is cause for concern and rescue med. Also, rescue med is very effective AND *FAST* acting.
I hovered betwixt 700 and 1100 throughout tx and only medicated when I dipped below 600 and 500 on a few occassions. On all occasions I did a shot a day for three consecutive days and CBC on 4th or 5th day after first shot. In all cases, I was normal, high normal, or slightly above normal in my ANC measurement with it dropping back to the tx range I previously mentioned.
It seems to me that you've come along way from where you were when you started tx and this is just another of those factors which do occur and it's good to be aware of them. This finish line is in sight and I would think that you should be able to cross it without this being any obstacle in doing so. Wish you well with remaining tx.
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