How low can platelets drop?

[Diana66]

How low can platelets drop? How is it managed? Through dose reduction? How much is the dose reduced?
I started tx with 122, went down to 83 in week 4 and now 77 in week 5

Hemoglobin bounced back a little from 104 to 112 since I started Telaprevir !!!!
Neutrophils up to 1.09 fro 0.83 a week ago (I got a bit of a cough though and that stimulated them)

[hrsepwrguy]

"How low can platelets drop? How is it managed? Through dose reduction? How much is the dose reduced?"

Table 3 Pegasys Hematological Dose Modification Guidelines

   Laboratory Values                          Recommended Dose
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ANC <750 cells/mm3                         Reduce to 135 mcg
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ANC <500 cells/mm3.                      Discontinue treatment until ANC values return to more than 1000 cells/mm3. Reinstitute at 90 mcg and monitor ANC.
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Platelet <50,000 cells/mm3                 Reduce to 90 mcg
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Platelet <25,000 cells/mm3                 Discontinue treatment

[Advocate1955]

My husband's platelets were 198 THOU/uL in August of 2011 before he started treatment.  They had dropped to 126 THOU/uL when he had to stop treatment in April 2012 (not due to platelets, due to tx not working).  They have come back up now , 7 mo after stopping treatment, to 158 THOU/uL.  He did not have any serious problems with platelets during this (triple tx w/Inc) treatment.
Advocate1955

[Dannyboi7]

As the others have said you started with a good platelet count and they do fluctuate back and forth during treatment,usually on average they drop around about 40 points from where you started.

  Since you don't have rescue drugs for your Neuts in your country,it's tough call wether to reduce your riba.You might want to talk to Kristina about that,hers drop to point .6 during treatment but she toughed it out with no rescue drugs,at that point you would be bed ridden.

[can-do-man]

I started treatment with a platelet count in the upper 70's and got as low as the upper 20's with no problems....... Platelets can and will rise and fall during tx. at any time.. Mine went back up to the fiftys all on their own during tx.

[HectorSF]

When you get below 50,000 the peg-interferon drug advises dose reduction to half. When below 25,000 the drug label advises stopping all treatment.

Bottom line - your platelet count is not and will in all likelihood be a non-issue for you because you have plenty of platelets to start with.

Cirrhotics with platelet counts under 70,000 before the start of peg-interferon treatment may not be able to start therapy because they may need interventions such as interferon reduction, Promacta or platelet transfusions.

Many cirrhotics have platelet counts below 70,000 normally. I have lived over the last 5 years with a platelet count less 60,000. No bleeding.

Cheers!
hector