Lab results - still confusing

[Junebug812]

Hi all,
I started tx for genotype 3 on 12/3/10. I'm really struggling and having lots of side effects but am determined to keep going, especially since I only need to do tx for 6 months. My VL was 0 at 4 weeks which was very encouraging. The other lab numbers are confusing to me though. My doctor is talking about putting me on another injectable because of my hemoglobin.

As of 1/27, this is where I'm at and this is where I started:

ALT  start: 27, now: 24
Hematocrit start: 39.7, now 29.6
Hemoglobin start: 13.5, now 9.9
WBC start 5.7, now 1.9
Platelet start 238, now 130
RDW/RBC start 12.9, now 15.1
Red blood cell count start 4.13, now 3.11
Absolute neutrophils start 2.7, now 0.8

These seem like the important labs(?). My doctor called me last night expressing concern about my hemoglobin levels. He asked me what side effects I'm having and I told him I'm having problems with my breathing. I can't walk two blocks without assistance or needing to sit immediately. My bronchial tubes feel all messed up and I cough so much that I now have chest pain. Before tx, I was very healthy, fit, vibrant. I am now a shell of myself. I have also lost 10 lbs since starting tx. I'm 5'9 and went from 145 to 134 in 5 weeks. My skinny jeans fit now, but hey, not even sure that's worth all of this!

My doc is going to do blood work again on Feb. 15th, mainly to see where my hemoglobin goes. What is this injectable he is talking about? Anyone know? Should I be worried about a 9.9 hgb? Anything I can do on my own to get it to move upwards?

Thanks for any advice.

June

[Bill1954]

Hi June,

Sorry to hear you feel so poorly. The injectable drug your doctor spoke of is generically known as ‘epoetin alpha’ (epo), ‘Procrit’ or ‘Eprex’ by brand name, depending on what country you live in.

It is used in for certain cancer chemo patients and can help boost bone marrow production of red blood cells. It also has notoriety as a ‘doping drug’ for cyclists, etc.

You’re hemoglobin is right about where intervention is required; typically something needs to occur around 10.0 g/dL to help you complete your therapy. At 9.9 you might feel poorly, but I understand some folks tend to acclimate slightly over time. The coughing, wheezing, and fatigue you’re experiencing are all typical of hemolytic anemia. You don’t have any preexisting cardiovascular issues?

Hopefully the doctor has performed iron studies to ensure you have adequate iron available for the epo to work with; if not, you might mention this to him just in case.

There isn’t much you can do in the meantime, other than to avoid undue exertion; don’t push yourself, stay hydrated and try to get adequate sleep to help you feel your best.

On another note, your white blood cells as viewed by absolute neutrophils are significantly low too, but not yet in need of intervention; be sure to keep an eye on those, as they might want to do something about that if they drop below 0.500.

Welcome to the discussion group, by the way-

Bill