Aa
Rescue Meds For Low WBC and Neutrophils
My Dr is threatening to stop TX if my WBC and Neutrophils don't go up by next labs. I asked him if there were any rescue meds for this and he said no and the only way to raise my WBC is with nutrition. So, my question is, are there any rescue meds out there that my doctor may not be aware of or any information as to how I can get my WBC count raised. Ive come to far to stop TX. My next labs will be in 4 weeks.
week 13 TX Riba/Peg
Genotype 3a
Baseline 12million
UND 5 weeks
UND 12 weeks
Neutophils (Absolute) 0.8
WBC 1.9
week 13 TX Riba/Peg
Genotype 3a
Baseline 12million
UND 5 weeks
UND 12 weeks
Neutophils (Absolute) 0.8
WBC 1.9
Best Answer
Stopping treatment is something most of our doctors will avoid if at all possible.
The usual course of action for low anc is either using neupogen or lowering the interferon dosage.
If you are not already taking calcium and vitamin D, you probably should be. Tx is hard on our bones, and neupogen is even more so. Plus there are studies showing vit D helps with tx.
I'm small and the full dose of neupogen was too strong for me. My hepatologist agreed to allow me to take a half dose, which worked as well for me with less side effects.
BTW: I did land up lowering my interferon dosage at week 12 and stopped taking neupogen altogether.( I was using it from week 2 to week 12)
The usual course of action for low anc is either using neupogen or lowering the interferon dosage.
If you are not already taking calcium and vitamin D, you probably should be. Tx is hard on our bones, and neupogen is even more so. Plus there are studies showing vit D helps with tx.
I'm small and the full dose of neupogen was too strong for me. My hepatologist agreed to allow me to take a half dose, which worked as well for me with less side effects.
BTW: I did land up lowering my interferon dosage at week 12 and stopped taking neupogen altogether.( I was using it from week 2 to week 12)
"Sorry, that wasn't the most compassionate statement, just blunt. "
Blunt is fine...You know, I'm not opposed to getting a new Dr, Ive been researching all day. Basically, if my doctor wasn't receptive to me using Neupogen instead of stopping TX, I was going to walk. He called after reviewing my fax requesting this and said that using Neupogen is an option....I still might walk.
Again, blunt is fine...the compassion came from you reading my question and taking the time to respond...thanks for that.
Blunt is fine...You know, I'm not opposed to getting a new Dr, Ive been researching all day. Basically, if my doctor wasn't receptive to me using Neupogen instead of stopping TX, I was going to walk. He called after reviewing my fax requesting this and said that using Neupogen is an option....I still might walk.
Again, blunt is fine...the compassion came from you reading my question and taking the time to respond...thanks for that.
"Doctors vary on how low ANC can get. Plus your own health and medical circumstances may be a factor. My doctor wanted me to start Neupogen when my ANC was .50. I asked if I could wait until my ANC reached .40. This is mainly due to the side effects I read about Neupogen."
My Doctor claims that if my ANC reaches .7 or my WBC reaches 1.7, he stop TX. Since posting this yesterday and recieving great responses, I faxed him 2 studies along with the request to use Neupogen. He called me and after talking for a minute, said Neupogen will be an option if my lab values continue to lower. He did give me some resistance which makes me wonder if I should trust him but the end result was he was receptive to the suggestion based on the information I presented to him.
I am to have labs on Jan 4th to check the levels again. I thought he would recommend a dose reduction or something....
I appreciate all the links you sent, I am buying the book for myself as a Christmas present.
My Doctor claims that if my ANC reaches .7 or my WBC reaches 1.7, he stop TX. Since posting this yesterday and recieving great responses, I faxed him 2 studies along with the request to use Neupogen. He called me and after talking for a minute, said Neupogen will be an option if my lab values continue to lower. He did give me some resistance which makes me wonder if I should trust him but the end result was he was receptive to the suggestion based on the information I presented to him.
I am to have labs on Jan 4th to check the levels again. I thought he would recommend a dose reduction or something....
I appreciate all the links you sent, I am buying the book for myself as a Christmas present.
Sorry, that wasn't the most compassionate statement, just blunt.
I see you're in So.Cal. You could take a look at this link for a treatment doc recommended by our members.
BTW: I changed docs the first time I did tx.
http://www.medhelp.org/posts/Hepatitis-C/Who-is-your-good-doctor-/show/1715783
I see you're in So.Cal. You could take a look at this link for a treatment doc recommended by our members.
BTW: I changed docs the first time I did tx.
http://www.medhelp.org/posts/Hepatitis-C/Who-is-your-good-doctor-/show/1715783
In honesty I learned about the timing of labs and when to administer Neupogen from the members here on the forum. I read studies and Neupogen-related posts on my own but without their input I would have ended up on higher & more frequent doses. In my case I administered Procrit on Thursday, Peg on Friday, Neupogen on Sunday and had my CBC on Tuesday.
Doctors vary on how low ANC can get. Plus your own health and medical circumstances may be a factor. My doctor wanted me to start Neupogen when my ANC was .50. I asked if I could wait until my ANC reached .40. This is mainly due to the side effects I read about Neupogen.
Another thing I learned on here is that low neutrophils do not particularly mean high bacterial infection with hep C patients. Here is a link from the Annals of Hepatology (don't use this since it is 6 years old and the ending sentence not exactly persuasive)
http://www.annalsofhepatology.com/PDF/vol5s1/Hp06S1-19.pdf
Dr. Melissa Palmer is widely respected in the HCV Community. Here is an excerpt from her book:
http://tinyurl.com/bnl3rug
Adherence to treatment
http://www.ncbi.nlm.nih.gov/pubmed/17660602
Doctors vary on how low ANC can get. Plus your own health and medical circumstances may be a factor. My doctor wanted me to start Neupogen when my ANC was .50. I asked if I could wait until my ANC reached .40. This is mainly due to the side effects I read about Neupogen.
Another thing I learned on here is that low neutrophils do not particularly mean high bacterial infection with hep C patients. Here is a link from the Annals of Hepatology (don't use this since it is 6 years old and the ending sentence not exactly persuasive)
http://www.annalsofhepatology.com/PDF/vol5s1/Hp06S1-19.pdf
Dr. Melissa Palmer is widely respected in the HCV Community. Here is an excerpt from her book:
http://tinyurl.com/bnl3rug
Adherence to treatment
http://www.ncbi.nlm.nih.gov/pubmed/17660602
If it was me, I would start lining up a new doctor, preferably a hepatologist, now. I would not wait until my neutrophils to drop and the doctor to cut off treatment. I would want to have an appointment lined up with the new doctor so no treatment days would be missed. Plus, there are other problems you could have in the future and it would be better to have a competent doctor treating you if that happens.
I actually did that when I was treating. My team said they were going to dose reduce to half of my dose if my anemia got worse. Contrary to what they told me when I started treatment, they said they did not ever give Procrit. I went home that day and made an appointment with a new doctor, a Hepatologist, 70 miles away. I should have done that much, much earlier in treatment. Treatment would have been much easier if I had had a competent team in the first place.
I actually did that when I was treating. My team said they were going to dose reduce to half of my dose if my anemia got worse. Contrary to what they told me when I started treatment, they said they did not ever give Procrit. I went home that day and made an appointment with a new doctor, a Hepatologist, 70 miles away. I should have done that much, much earlier in treatment. Treatment would have been much easier if I had had a competent team in the first place.
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What are Neulasta® and NEUPOGEN®?
Neulasta® and NEUPOGEN® are both white blood cell boosters. They are man-made forms of a substance called granulocyte (gran-yoo-loh-site) colony-stimulating factor that is naturally produced by the body. They stimulate the growth of a type of white blood cell called neutrophils, which are important in the body’s fight against infection.1,2
http://www.neulasta.com/starting-chemo-with-neulasta/about-neulasta-neupogen.html?src=ppc&WT.srch=1&SRC=2