Dose reduction?

[Andiamo1]

Does anyone have an opinion on Peg dose reduction for neutrophil  of 650?  I have a friend that is experiencing this and being told to reduce peg.  I seem to remember that mine dropped once and my doc said not to reduce.  Personally, I think dose reduction within the first three months of treatment is to be avoided except for very serious side effects.

Eric

[Andiamo1]

Thanks for the input.  I will pass that along.

Eric

[jmjm530]

Using the helper drug Neupogen is preferable to dose reduction. That said with ANC 650 neither may be required. My ANC dropped to 320 and I was allowed to continue full dose without Neupogen. A few weeks later ANC was over 1000 all by itself, ie ANC has a tendency to bounce around a lot.

[nygirl7]

Just wanted to say at 22 weeks post you are as SVR as you are ever gonna get Eric - get used to saying it, its for real!

Tell Mafalda it was her love who worked this miracle in you - after all the years of not giving up that woman is not only beautiful but she is a SAINT ;)

Deb

PS MY ANC went down and my doc didn't jump the gun on the neup and they went right back to where they were solid. Tell him to just give it a week/few weeks and have another CBC - they'll hopefully be right back where they should be DONT DOSE REDUCE ARGH!!!!! - not unless absolutely necessary and certainly not at that high a number!

Tell your friend good luck!

[Andiamo1]

Thanks all for the comments.  I am sure they will be very helpful.

Eric

[Trish77]

There is no need whatsoever to cut back on the Peg based on that number alone. Unless there are other mitigating factors, such as trial participation, I would strongly fight it, particularly in the first 12 weeks to the point of getting another doctor.  I would also ask for a rescue drug on the logic that if the ANC is considered low enough to do something as drastic as reduce life-saving drugs, then certainly a rescue drug like neupogen is allowed.  Again, if this is a trial situation and it IS allowed, one may have to fight for it a little harder.  If not a trial situation, then fight for it to the point of getting a second opinion.

Because I've faced this on an ongoing basis within my trial situation, I'll end up piping up to say that anybody, whether going into SOC or a trial, should have a conversation with their medical team on what conditions they agree to use rescue drugs and when dosage reductions come into play and go with the team that fits what you feel is best for you.

Good luck to your friend.

Trish

[can-do-man]

650 seems a bit high to even think about reducing, mine got as low as 300 and my hepo wasn't worried. Two weeks later they had went up on its own and bounced around all thru tx.

cando

[Marcia2202]

Good to see you posting! You've been gone for quite a while! Hope you're good.

Marcia

[CockSparrow]

I agree with Marcia, I'd want to try the Mushies first before reducing.
Dose reducing before you are und doesnt appeal to me. Cause if you have to you have to.

They may even bounce back by themselves.
There is still a little room to move with .650.
From memory gaufs got quite a bit lower than that.
I would try and avoid dose reducing unless you have no choice.

CS

[Marcia2202]

I was just wondering, if your friend could stall the reduction for a week and consume Shiitake supplements or the mushroom itself to see if it brings up the whites. I remember Susan400 talking about this. She was in a trial and wasn't allowed rescues nor supplements. The trial nurse suggested she eats a lot of these mushrooms and it helped.

My hepatologist has told me that they don't give neupogen and will reduce if they drop too low, so I am having Shiitake preventively every day until my Shiitake supplements come. I will stay on them throughout tx I think.

Marcia

[fuzzy1dar]

I'm so sorry to hear that you've had to treat eight times!  

I so hope this last tx is the one that will bring SVR dreams come true!  I can't even begin to imagine having to tx again!  

Being UND for 22 months is great news!  I've heard good things about teleprevir.

I tried ambian while on tx and had a very bad reaction. I don't know if it was from the ambian or the interferon, anyways I'm afraid to try anything else!

I hope you get some sleep tonight!  If you're in FL I supose its almost daybreak.  Did you get any flooding where you are?

darla

[Andiamo1]

I have treated eight times.

I tried everything for the insomnia and nothing really works to my satisfaction.  Some of the prescription meds help me sleep, but they leave me hung over.  The rest do nothing.

Glad to hear you are on the mend.  I hope we can share the SVR!

Eric

[fuzzy1dar]

Glad to here you're UND!  Looking forward to seeing your post of SVR soon!  I also have a major case of insomnia.  Do you take anything for it?

I'm 5 weeks post tx and on the mend!  How many times have you txed?

take care...
darla

[Andiamo1]

I am 22 weeks post treatment.  I was undetectable at 12 weeks and I am hopeful for SVR.  I am feeling much better thank you.  I still have a major case of insomnia though.

I don't remember it lasting this long after treatment stopped following any of my other treatments.

Thanks for asking.  How are you doing?

Eric

[fuzzy1dar]

In my opinion it would depend on if there are rescue drugs on the way.  My doc let mine go to .5 before precribing neupogen. As I've heard many people say its not too bad until the ANC gets below .5. You're friend should stay away from anyone who is sick and I would recommend staying away from big crowds.

How are you doing with your tx?  I hope you're feeling well !

best of luck to you and you friend!
Darla