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4896357 tn?1360674504

WBC Count Low; Told To Skip 2 Interferon Shots.

I don't have the numbers but the Doc's office help called me the morning after my latest CBC and I was told to skip 2 shots. She said the number had to have been below 2. I don't have insurance and can't afford special drugs or blood transfusions. Any opinions on this? How will this compromise my tx? I'm on week 18 of Peginterferon, Ribaviron & Victrelis. I thought I was doing pretty well, just mainly short of breath.
33 Responses
317787 tn?1473362051
Hi, I am assuming you are UND.  I had to reduce my interferon and in fact once I was told not to take a shot until my numbers came back up.
But two? I would think (in my inexperienced opinion) that you would skip one, they would draw blood to see how you are then go from there.
Kind of odd to skip 2 without blood draws.
I would also think your WB could be way under 2.  When I treated mine went down to 1.4, I continued to treat.  That was after 6 months of tx.  I could go look at other blood work to see how low it went.

The thing they were worried about for me was the Neutrophils and Lymphocytes. something about going below .50

I am sure that others with more experience will be here soon.  I just wanted to check in
Shortness of breath is awful, I had that with my low HGB.
4896357 tn?1360674504
I believe that my last VL test was at 8 weeks and I was detectable but down to "9". These tests are the most expensive part of my tx at $500+ each so we agreed to minimize them and I will get one at 24 wks and 36 wks and 6 months after completing 48 wks of tx. The CBCs are only $15. I am probably und now but won't find out for 6 more weeks. Of course if I am not und at 24 & 36 wks, tx will be stopped. I hate these shots but am worried about skipping 2 of them. The office girl told me that you can skip up to 4 in a row.
Avatar universal
Rate of Infectious Complications during Interferon-Based Therapy for Hepatitis C Is Not Related to Neutropenia

"....Despite these concerns, this analysis demonstrates that systemic antiviral therapy for HCV infection is associated with a low risk of infectious complications. The majority of these infections are minor. There is an absence of correlation between the neutrophil count and rate of infection in recipients of IFN-based therapy for HCV infection. Even in patients with neutropenia, the majority of infections occurring during therapy were of minor consequence and did not require hospitalization or modification of treatment for HCV infection. We conclude that, in most cases, reduction in IFN dose and/or the use of G-CSF in those developing neutropenia is not warranted..."

http://cid.oxfordjournals.org/content/42/12/1674.full#F4

Risk factors for infection during treatment with peginterferon alfa and ribavirin for chronic hepatitis C.

"CONCLUSION:

Bacterial infections during treatment with peginterferon alfa and ribavirin are not associated with neutropenia. Older patients and patients with poorly controlled diabetes mellitus have a greater risk of developing infections during HCV treatment..

http://www.ncbi.nlm.nih.gov/pubmed/20830784
4896357 tn?1360674504
I did do some research on this and found a definite relationship between Neutropenia and Interferon, although all were relating to cancer chemotherapy. Yes, Interferon is a chemotherapy drug. It seems that if the WBC count drops below "1" that some intervention is needed to boost the immune system. I don't have insurance and can't afford to land in a hospital. I would have thought that reduced dosage of the PegInterferon Redipen for a couple weeks would be worth a try. Maybe the Dr. is being extra careful that I don't end up hospitalized and bankrupt...

Mike, at what level are we considered to have neutropenia and at what level is emergency intervention called for?
Avatar universal
An ANC of less than 1500 per microliter (1500/microL) is the generally accepted definition of neutropenia. Neutropenia is sometimes further classified as:

    mild if the ANC ranges from 1000-1500/microL,
    moderate with an ANC of 500-1000/microL, and
    severe if the ANC is below 500/microL.

Treatment depends upon the cause and severity of he condition as well as the underlying disease state responsible for the neutropenia.

http://www.medicinenet.com/neutropenia/page2.htm
223152 tn?1346981971
Can you get a copy of that CBC?  When they tell you the number is under 2, I am thinking they are referring to the complete white blood count.  Carl, it is not unusual for the WBC to be under 2 on tx.  In the two times I have treated, my WBC has rarely been over 2 for the entire treatment. A lot of  doctors get all bent out of shape about this, but it is the absolute neutriphil count (ANC) that has more meaning, and even then, that can go as low as .5 like dee said before it becomes an issue.  IT would be helpful for you to get your actual numbers and post them here.  I had neupogen but only took a couple of shots the whole of my 48 weeks.

Bean
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