Low Neutrophils

[Diana66]

Since I started tx with a base of 1.64 I have been flaoting around the 0.56-0.7-0.88-1.05 for the last 14 weeks

Today all of a sudden I bottomed to 0.3. This is on an already reduced Interferon dose of 135. I am waiting to hear from the doctor now of what the plan is but would this sudden drop be just from the Interferon or is it possible to have other reason as well

2 weeks after the Incivek: Hemoglobin at 10.1, Platelets at 58 so only the Neutrophils are the problem

Any ideas, suggestions?

[Idyllic]

Wow I know you have other issues but I wonder about missing an Interferon dose as well. I remember once I asked a question about the half life of Interferon and Riba dosing and the long short of it is that Riba gives the Interferon Ooomph. Though it varies for everyone ANC hikes up pretty fast after the Neupogen.

Since from what I gather, in this respect you are not in dangerous territory with the Peg. Since Neupogen does kick in relatively rapidly it seems like keeping you on Interferon and administering the Neupogen and making dose adjustment decisions based on the labs right after that.

[can-do-man]

I agree with jules, ok after telaprevir skipping shots. I don't recall any talk of reducing or stopping the interferon at any time. The Riba, reducing yes.......... Maybe it's out there but I don't remember it.

[jules2551]

I would never suggest skipping an INF shot. You really need to talk to your Dr about Neupogen and see if its available to you. Which I hope it is.

[flcyclist]

Curious if the doc discussed neupogen as well.  Sounds like a good plan otherwise.  

[Diana66]

Ok, so the advice is to give the dose a miss this week, retest neutrophils in couple of days and restart  Interferon at 90 when Neutrophis >0.5

It seems that this is ok to do since I finished Telaprevir

[jules2551]

The first time I had to take a Neup shot my numbers shot up to pre-tx numbers and lasted about 4 weeks.  Then we had to start doing Neup shots about every other week and now I have to do them basically every week.  I am on week 35 and today my ANC was .43.  

So I have to agree with flcyclist that the Neup rebuilds quickly, within 1-2 days, then the effectiveness wears off throughout the week.  Then it's time for an INF shot and the ANC tanks again.  One helluva balancing act!  :)