WBC Count Low; Told To Skip 2 Interferon Shots.

[Carlhcv]

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.

[can-do-man]

Not sure what makes your doctor think with that level you might end up in the hospital, and I agree with Mikes statement risk of infection is really low....... My ANC got as low as .3 and my doctor never freaked but he also deals with TP patients.

As for neupogen, you can get that for free also, many here have. She can't find your ANC levels? Oh my, is she also the one who said you can skip up to 4 shots?

Sorry but the care your getting doesn't seem to good.

[Carlhcv]

I appreciate all of the feedback. I got some info from the office girl. WBC is 1.65, This can also be expressed as 1,650. She couldn't find an  "ANC". RBC is 4.1. Hemoglobin 12.4. My Doc knows my financial situation and is trying to keep me from ending up in a hospital. He is treating me for free and I'm getting the meds for free. You guys are not doctors and cannot advise me to go against his orders but I am leaning toward either doing a low dose shot for 1 or 2 weeks or skipping just 1 week and getting a CBC before the next shot. I don't want to jeopardize my tx because my doc is being extra cautious.

[ppmguy]

           my lab work comes back as wbc with differential.  mine was below 2  most of tx.  when my wbc with diff. hit 1.6, my dr had me reduce my peg to 135 mcg, for one week. i questioned my dr, and she replied that was tx protocol.  the next week my wbc was at 1.9 and cotinued at full dose.  
            when i was on soc in 2008, my dr had me skip a full dose and i became detectable.  peg inf has a 5.7 day half life, so i would question my dr.   dont have the knowledge to tell you yhat the VIC and RIB can sustain your status without peg.
                                             barry

[medic54]

Check the Nupogen thread a few prior to yours here. A post by Bill1954,
re- med help purchasing (Nupogen) through needymeds.com

[medic54]

he started me on Nupogen ("or we'll have to cut back on your Peg") when my proceeding labs came back:
1- ANC  462*
2- ALC 1085
3- WBC  1.9
It was all about the ANC as my WBC total had dropped lower before and not a word about it. Lymphocytes dropped from pre-treatment but were still within normal limits. Read studies stating that with HCV 300 should be OK and that it doesn't get dangerous till about 100. Nupogen worked for me with one shot every 10 days (155#, 59 yrs, stage 3, peg-180/d, rib 1000/d).
Good Luck

[medic54]

To my above post I will add an event in my treatment: I was plagued with neutropenia throughout treatment and my doc was fine with it "as long as it stays above 500". It hovered between 550 and 650 most of the time. I eventually went on Nupogen the last 2 months but prior to that I get a call from another one of the gastro docs in his group (weekend coverage detail) and she's near panic telling me my labs just got back, my ANC is 550 and I need to cut back on my ribavirin (now this is a board certified gastroenterologist believe it or not) . Well, I ignored that (it's the economy stupid) and the next week my regular doc concurred with my call...but as they're all in the club, did his best to CYA her incompetence.