blood work results

[Krazilou]

I've been lurking for awhile, finally have the courage to ask a question.  I've begun peg-intron combo treatment, 5th injection will be Sunday. Type 1a.  2nd week blood work very discouraging, or at least thats the impression I got from Dr.  
3.6 WBC-  3.74 RBC-  10.8 Hemoglobin-  32.5 Hematocrit--  MCV 86.7-  MCH 28.9-  MCHC 33.3-  RDW 14.8-  platelet 212-  Absolute Neutrophils 2556-  Absolute Lymphocytes 839-  Absolute Monocytes 184-  Absolute eosinophils 18-  Absolute Basophils 184.

  Anyway....is the drop taking place to quickly?
I got the impression that he didn't think I could tolerate the treatment, next visit would decide that.(that would only be 8 wks) I asked him about procrit, that will be discussed Oct 14?(isn't that suppose to help?) (52 wks was the orginal plan) Viral load results were taken with 3rd wk bloodwork, which he didn't have yet.(orginal 3,250,000.)
He said My counts were "dropping like a rock", decreased ribavirin from 1000 to 800 mg.  Is this a "normal"?
I asked questions, but I did not understand what deciding factor determines continuing.  treatment. He said I need a 2 log drop by 12 weeks,(which I understand)
I'm very weak,etc...but not enough to quit. This is the 3rd time around; 4 months interferon 98/99 non-respond; then 4 months Rebtron in 99,1 month 1/2 dosage-treatment stopped (had blood problems then also).No one said anything about procrit back then.  Won't medication stop the drop in blood cells?
Sorry this got so long-my mind can't seem to phrase a simple question.LOL
  I just can't understand how 2weeks in and he might have thoughts of discontinuing already. Does anyone  have this problem too? Any suggestions about what I should ask the Dr.?
Learning every day:-)

[Shell1229]

test

[Boulder]

Krazilou,

I think you still have wiggle room for your wbc. During my tx, wbc dropped to 1.2 and my doctor said the same. However, wbc stabilized and I continued without dropping the dose at all. We are all different and so are our doctors. Don

[oldhippiechick67]

My blood work at week 4-5 was about the same or worse than yours and my doc didnt take me off or change anything.  Guess you will have to wait till you see him but my 2 cents says you are okay for now.  Hope ya can stay on tx and beat it this time!!  best of luck to you !   OHC

[Steve']

Well you're at the right place here, the people are great... keep a positive mind frame going all the time ... like oldhippiechick67 & boulder say that theres was the same or worse but stablized & the dr kept them going on Tx... try not to worry so much I know its easy to say because you've played this game before tried treatment (Tx) a few times ... so you've definately got the motivation going strong, which a lot of us dont have much of hahaa .... Good Luck, keep going strong ~~~Steve~~~

[MajNeni]

Hi, Lou,
It is common to have a big drop in the beginning.  You've wallopped yourself with Ribavirin, which is hemolytic (kills off red blood cells prematurely).  The drop is usually most dramatic early in tx.  I've read the average drop is 3 points on the Hgb in the first 2 weeks; then it usually gradually tapers off.  You're not in any danger yet with these numbers, but you might be feeling crummy, especially if you're a guy; women's Hgb is normally a tad lower than guys'.   I recommend having CBC's often, and keeping Procrit as an option.  Remember, too, that it takes Procrit 2-4 weeks to kick in after you start.
I've had weekly CBC's, with the first one just 3 days into tx; been on Procrit since week 2 and Neupogen since week 15.  I've had my doses reduced 2x, so I'm going to ask for another pcr at 36 weeks; 12 week and 24 week tests were good.
Maj Neni