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Avatar universal

WBC crashed

I could use some help. I had a blood test yesterday and I got a call at 12:15 am from a Doc that my WBC was 1.8/.800 an I need to call my Doctor. I checked my records and my last WBC was 3.3/1100. I am on week 11 of 48 is their something I should be doing? I see the doc Tuesday any questions I should ask? I have not slept sence that call. Thanks Jerry
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Avatar universal
well i was worried about 3.3 WBC, so maybe i can cool off a bit.  i'm week 3, Type 1 or 4, and all my blood counts are right down.  its a bit scary to see everything suddenly underlined as below range. maybe if İ post them here someone could give me some advice before i go back for week 4 blood test and shot.  i'm on Peg İntron  2b Schering, first 2 doses 80, third dose 100 and subsequently 100.   also taking 1000 riba and since i saw my blood test, Bachs Rescue Remedy!!  Ok someone please tell me how low can i go.
WBC 3.3 K/uL
LYM 1.2 K/uL
MID 0.2 K/uL
GRA 1.9 K/uL
RBC 3.52 M/uL
HGB 9.9 g/dL
HCT 30.2 %
MCV 85.6 fL
MCH 28.3 pg
MCHC 33.0 g/dL
RDW 11.8 %
PLT 95. K/UL
MPV 11.4 fL

and do they keep going down?  
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Avatar universal
My WBC have been around 2 since week 4 or so. Week 8 they went up to 2.6, but now at week 12 they are back down to 2.1.
What my Dr told me was that they where stable. That they where not a concern unless they dropped below 1. She actully told me they allow them to go to .5 if you can believe that.
The last thing you want is dose reduction. Just play the game, and see what happens. Definately ask about the Nuepagen now, and tell the Dr up front that there will be NO dose reductions. You are not allowing him to reduce your chances!!
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Avatar universal
No need to have any kind of immediate worry about your WBC and neutrophil levels - they are higher than mine were before I ended up on Neupogen. You can safely stay at those levels and not be in danger of serious infection.

That being said, you need to go over with your doc on Monday about getting you set up for Neupogen <b>before</a> he/she wants to lower your dose, since dosage reduction is murder on SVR odds. Neupogen is guarenteed to work in raising your counts (though you may end up taking it for the rest of your tx).

What you also need to do is call your pharmacy right away and find out how quickly they can get it to you after it is ordered, since this is not an off-the-shelf item. And call up your insurance company to find out about your coverage of it.

The important thing is for you and your doctor to be proactive in this. There is no need to wait until after-the-fact and then have your dosage cut or skipped, when the whole time it's just as easy to put you on Neupogen right away - knowing that it will boost your white counts up immediately and keep you on track without having to lower your SVR chances.


TnHepGuy
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Avatar universal
I wish to thank all of you for your advice and knowledge, that midnight call had me going crazy!! I will push for Neupogen before a reduction in meds. Its only been 11 weeks but I want a fighting chance to kill this dragon. Thanks again Jerry
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Avatar universal
Relax, call your doc when you get a chance.  You're not going to die from it.  Neupogen is an option and so is a dosage reduction, though at week 11/48 it is perhaps too early for that.  I had an interferon dosage reduction in week 29 of 48.  My WBC had been 1.1-1.3 and neutrophils were 444-550 for several weeks.  I never got an infection, cold, flu or anything.  By the way, I was 1b genotype and just recently had bloodwork done that indicated I am SVR 9 months post tx.  A lot of folks here take Neupogen but it is expensive and your doc may be reluctant to prescribe it particularly if you are in an HMO (you know how they try to keep costs down).
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Avatar universal
Yes you can ask for neupogen shots. The first thing that came to my doctor when I had the same problem was to reduce my peg-intron dose. I came here to this site and they advised me to keep the dose as it is but ask for the neupogen shots. I did and he agreed. This was at week 11, the same like you. I then kept taking neupogen till the end of therapy, of 48 weeks.
Good luck.
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