low neautrophils, low wbc

[cougareyes]

This time of colds and flus are abound and I'm sure like myself some can get germaphobic. Interferon causes a lowering of the wbc and absolute neutrophils. So when should we get concerned and what are some of the signs to look to Neutropenia.
I've battled sinitis and congestion problems throughout tx, this came with a cough; things have never got out of hand. My wbc and neutrophils have all been in good range.
Everyone Be Well......Peace

[friole]

I think the problem with the drop in neutrophils is that there really are no signs.  If you start to get a lot of infections that don't heal, or sinuititis and respitory problems that may be an indicator, but in your case, you say you have those with ANC and neutrophils in the normal range.  I figure this is one area to be left up to the doctors.  Problem is, most of the hemotologists deal with cancer patients, and cancer patients cannot tolerate ANC dropping as low as Hep C patients can.  My doc didn't want them below .8 and I fought starting Neupo for a month, but when they dropped to .4 I caved. Now, even with Neupogen once a week, they are dropping to .6 right before my shot.  I have my grandkids over a lot, and they always have something, so I fell now that the Neupo is a good thing.

[jmjm530]

Unlike hemoglobin, your ANC (absolute neutrophils count) can bounce up and down dramatically without rescue drug intervention. Mine have been as low as 325, the next week 800, a week later 1700 and a week later back to 1000. Some doctors intervene with Neupogen at ANC 1000 but most of the agressive treaters wait until it's below 500. My medical team rarely uses Neupogen (they are very agressive with Procrit) and waits until it drops to the 200-300 range. Their decision is based on ANC, not the WBC count.

Regarding infections, etc, studies suggest that the kind of neutropenia (low wbc) we get on interferon treatment is different from other forms of neutropenia. The conclusion if I remember correctly, was no additional infections were seen with low wbc while on treatment. I'll see if I can dig up the study later.

-- Jim

[jmjm530]

This paper suggests ANC of >500 not associated with infections on combo treatment. It's not the paper I was looking for which suggested safety limits lower. If you go to projects-in-knowledge you can go into this more in depth. I pretty much panicked when my ANC hit 325 and emailed my doc and NP right away. They both said it's probably an infection I have and to give it one more week. Sure enough it shot right back up. Your mileage may vary.

http://www.hcvadvocate.org/hepatitis/About_Hepatitis_pdf/1.1_Hepatits_C/Neutropenia.pdf

-- Jim

[bobbyullc]

HEY WHILE YOU ARE ON LI YOU SHOULD TRY AND GET SOME L I PRESS CLIPPINGS FROM THE BIG ONE.NEED A DATE?
BOBBY