Low white blood cell count and platelets......I'm scared

[snowbyrd]

Just got a copy of my labs yesterday and things didn't look too good wbc and platelets are low. My dr has been away for a couple of weeks so i finally got a call from the clinic. I apparently can't go out were there are crowds and not be around anyone who is sick. I'm genotype 2 and take 800mg riba and pegasays. I took shot number 7 last night and i don't want to have to stop treatment.....Any suggestions??? Thanks

[1oftheclub222]

http://www.mayoclinic.com/health/neutropenia/MY00110

here is a link to the Mayo Clinic, it talks about have Neutropenia (low count of neutrophils)

[1oftheclub222]

You may want topost this question as a new question in the hep C forum, you will probably get more responses.  there are alot fo smart people over there that know about this kind of stuff.

[1oftheclub222]

I am guessing it's your abs. neutrophils?  those are a type of WBC that helps to fight off infections.

When it hits .5, that seems to be when doc's and insurance companies consider using a rescue drug.  

if your Abs neutrophils get to low, I think it can cause a problem if you get sick or hurt, you may have a problem fighting off  infection.

[acedave]

i m starting my 3rd month of hep c treetmint my viral load has droped from 14000 down to 76 in first month todays blood test well hopefully say its down to 0!  but dr just caled and said my white blood sell count has droped from 0.9 to below 0.5 what doe3s this mean ? i weell be starting another injection tomarow to tree the white blood cells.

[medicmommy]

Do you have an idea why you have the fever? Are you on treatment or are being treated for a medical condition as well as the hep C? Pain anywhere? Burning with urination or flank(side) pain? Any cough or trouble breathing? A fever just indicates your body is fighting something. Even with hep C, the occasional Tylenol for a fever or muscle pain won't cause irreparable damage to your liver and is better to take than Ibuprofen. If the fever has persisted more than 24 hours or does not respond to Tylenol,  you need to see a Dr....I hope you feel better soon...(((((((((((HUGZ))))))))))  ~Melinda

[tabitha78]

I have genotype 1a and my 7 year old son as while. My wbc is 2.3 and my platelet is 70.I'm running 100.7 fever and chills what should i do?

[medicmommy]

Hi Hopeful!
The date on this post had me curious, so I scrolled down and found you! There are so many things you can do to address the sides of txing, to make it tolerable...When do you start? Hey, before you answer that, would you mind starting a new thread with just you on it? I'm sure you'll get a lot more responses if you do...((((((((((HUGZ)))))))) ~Melinda

[hopeful587]

I'm Hopeful, and I'm happy to know that you are out there sharing info and encouraging one another.  I was diagnosed  with hep c 8 years ago.  Current cbc shows low platelets, 91.  Liver biopsy (my 4th) this week.  So I've accepted that there has been some damage.  Am geared up to start treatment.  I have  only one year of insurance left on my Cobra.  I am Genotype 1b.  I have a good amount of head knowledge from reading, but really need some good advice for better tolerating tx side effects.  How often do you actually see your doctor?  Thanks for your feedback and support.  I will keep you all in my prayers.

[Dale_Ray]

Snow: I experienced the same thing during treatment. I don't really know if the rescue drugs made me feel any worse than I already did. I do know that I did get positive results from their use. Your doctor should be watching very closely now and probably on a weekly basis. If so they will be able to regulate the counts to a certain extent. I wish you well and praying for a happy journey with a rainbow at the end. Dale

[chcnme]

Hi snowybyrd, first I have to say it was neat seeing that we have a conversation going on here between a snowybyrd and an orphanedhawk. You all have to stop meeting like this.  :)

Anyhow, you're on a week 7, and your platelets are still looking pretty good. Your anc isn't terribly low but it's going down and might continue to go down, might not, it's a wait & see.

Neuopogen (the drug Wyn and OH and others have talked about has (according to my doc)  also been shown to increase platelets in some patients.  Your platelets are fine, though, and so that's just a tid-bit of info (from what my doc has said)  just in case your ANC AND platelets keeping going down and you go on Neuopogen (it might have an added benefit.)

The Neumega is a drug used to increase platelets, but for whatever reason both of my docs say they don't use it; they use only the Neuopogen. I don't know why, but I've not seen many Hep C tx'rs on the Neumega.  

Anyhow...if you go on Neupogen at some point, I've heard from some it can cause some rather intense bone pain, BUT they said it was bearable AND that they were able to get through Hep C treatment ON Neupogen.  

Best of luck to you.  

[orphanedhawk]

I was told that although a platelet count in the 90's is below average, it is not a problem. My doc will let my platelets go as low as 25 before he'd consider stopping tx.
  I have been grabbling with low platelets and wbc for several weeks. First my interferon was lowered. Now I'm taking neupogen and doing weekly CBC's. The neupogen does give a boost in energy. I'm delighted that my platelets went from 32 to 62! You are fine, and believe me, you have lots of company here.
   White blood cells protect us from virus's etc. This is why you were told to stay away from people. I'd just make sure your kids friends aren't sneezing on you. Neupogen will raise your wbc count.

[FlGuy]

The reason I asked about length of hep-c is because of your platelets.  It seems to be fairly common for those who have had hcv for a long time to have persistently low platelets as well. But it's not a significant issue unless they plumment to the 30 range.  The blood doc I see won't take any action until they hit 25, and they won't go that low (I've done this before).  So, since they won't go that low and there's not much that can be done anyway, I invoke the Scarlett O'Hara attitude: 'Fiddle dee - dee, I'll worry about it tomorrow'

[friole]

I never had the platelet problems, but my white counts almost all during tx never got above 2.0.  I used Neupogen for almost the whole time and they stayed around 1.5.  The ANC ranged from .4 to 1.0.  I hope you are getting weekly CBCs so you can tell if it drops any lower.  Neupogen works well and quickly but it goes away quickly too. Sounds like you may be in need of it soon.
frjiole

[snowbyrd]

I was diagnosed last Aug I figure i have had it for at least 20 years so far no liver damage. My husband is a firefighter so we lucked out with the medical coverage. But here in Canada everyone is intitled to treatment. We have universal health care. I really feel bad when i read about all the people who cannot treat because of coverage. It is so sad that people have to wait till it is almost to late. I'm very happy to have found this place. I do have a support group but it only runs once amonth. Thanks again everyone.

[wyntre9]

My WBC's have been similar to yours.

So far 1.7 has been the lowest.

Once they hit that level, Dr. put me on twice monthly neupogen injections to counteract the decrease in WBC's.

My understanding is that these additional meds are common 'rescue drugs' used to help patients tolerate and withstand TX.

Lots of folks here are on the same stuff, and more.

[snowbyrd]

Did you get any side effects from the rescue drugs. I feel so tired and run down i hate to add something new to the mix. Although i guess the doctor will warn me of the risk of not taking rescue drugs. I wish i could just make it a few more weeks at least till week twelve. If I'm undetectable when my 4 week pcr test comes back i'm thinking about stopping at week twelve or 16. Do you feel any better, more energy? Thank you for your input.

[orphanedhawk]

I know you directed your question to Wyntre but I've been taking Neupogen (rescue drug) for a few weeks now. It definitly gives me a lift. In fact I felt so much better, I was surprised. And it acts fast. There are some negative sides, sore muscles. I haven't felt so down in the dumps, since I started the neupogen. It'll help you too.

[snowbyrd]

I thank everyone for there support. I don't know what the Dr is going to say when he calls. I just kind of got freaked out when the nurse said not to be around crowds and sick people. I have 4 kids 2 are in school so god only knows what the heck they bring home every day. I was able to take a leave from my Business so i do stay home a lot more . But i don't want to spend the rest of treatment in my house. I have to admit this tx has been a lot harder than i thought it would be. But i hear that geno 2's fair well with tx results. Thanks again to everyone. I know Canadian labs are different than the U.S so it is not as easy to read.

[FlGuy]

Assuming the reports used in Canada are similar to those that I see, the .5 relates to 500 absolute neutrophil count.  They are the white blood cell components that are the 'infection fighters'.  Docs might intervene at a point around 300 - 500.  Interventing usually mean an injection of Neupogen (google it) it's also referred to as filgrastim and is a colony stimulating factor.  My expereince is that Neupogen works quickly (within days) and raises the anc's.  But, what goes up will usually come down again.  Those who require Neupogen likely will require it again during the course of treatment.  The stuff is pretty expensive and I understand that in Canada insurance coverage can somtimes be tricky.  Have you had Hep-C for many years, and recently diagnosed?

[Cindy10]

Platelets can go pretty low. Hubby on tx and his are 40,000 and doc not concerned yet, however your WBC is low.

[FlGuy]

To follow on to what Mike said...Readings from labs can be confusing.  Platelets are sometimes listed as (for example) 100, when the actual reading is 100,000.  It's just the scale that is recorded on the report. Being at that level at week 7 probably means that you were lower than normal (or in the low range of normal) when you started. Lowering platelet on tx is not at all uncommon. (mine were in the 80's last week and still dropping - week 17)  The doc tells me there is no remedy for low platelets indicated for HepC treatment patients. Although, there is a drug (Numega) which is sometimes used for chemo patints.  But, I'm told, the use of Numega brings another whole set of issues. But platelets should not be a concern to the doc until they dip below 50 and then deserving of attention, not necessarily action.

[snowbyrd]

neut  0.5  normal range 1.6 - 7.4  is this the anc you are talking about

[mikesimon]

Ribavirin impacts red blood cells and hemoglobin. Interferon is more involved in platelet decrease and WBC decrease. I don't see a problem with your platelet count but your WBC is quite low according to our labs and standards. Here most doctors don't worry about platelets till they get to 50,000 and some are okay until 30,000 before they get nervous. We usually care more about absolute neutrophils as a significant marker but with a WBC of 1.6 I wouldn't be surprised if your ANC is pretty low. But regardless a decrease in Ribavirin doesn't seem appropriate to me. Mike

[snowbyrd]

What is the normal course of action for someone with low wbc and platelets. I read somewhere that they will lower your riba or stop treatment. I don't want to give up.... i think i have a good chance of clearing. I'm waiting on my 4 week pcr results.