pro

Apologize for writing my message in html format. This is because I couldn't figure out how to put the following table in text format properly.

The following is my wife's blood test counts.
She had her first chemotherapy (ACT) on may 7. This coming Friday would have been her second chemo. But most likely, doctor wil delay the second one if lkc and neuta remain this low as stated in the last line of the following table. My questions are:

1. what are the possible reasons for her lkc and neuta to go this low?
2. any drug can boost lkc and neuta?
3. if there is, why doctor would not prescribe?
4. anyone had similiar experience? Is this (low lkc and neuta) a common experience for patients?

hb pcv plt mcv lkc neutm neuta
16-Mar 144 0.441 249 91.2 6.2 3.6
28-Apr 140 0.423 228 91.7 6.8 3.9
26-May 144 0.437 317 92.5 2.5 0.9

Sorry for my super long messagel. Thank you in advance!


Regards,

j.s.

allan grossman

Hi - and welcome. Here are my answers to your questions -

My wife had ATC - chemotherapy targets cells with rapid cell division
times - like mucous membranes, hair follicles and bone marrow. The
bone marrow suppression is what causes the low blood counts.

Neupogen for white blood cells and Procrit for red. I don't think
there's much they can do about platelet counts except wait.

The drugs are very expensive.

Yes - this is completely normal.

Hope this helps -

--

we don't see things as they are, we see them as we are.
-- Anais Nin

guesswho

The chemo peaks about two weeks after chemo when it reaches it's nadir.
The doctor will perform a calculation called ANC- this looks at the where
differential too make sure there are plenty of new cells being produced. I
am sure they will do another count prior to chemo.This is the time your wife
is most likely to get an infections so best to avoid sick people.
How is your wife feeling ?

j

Alan,
This was just recently posted to sci.med.diseases.cancer (which is the first I've heard of)
http://my.webmd.com/content/Article/86/99100.htm?z=1728_00000_1000_ln_02
Two popular anemia drugs are under scrutiny by an FDA advisory panel because of ongoing concern that
the medications may lead to early death in some patients with cancer and other diseases.
Company officials said that several trials testing EPO drugs in patients with lung cancer, breast
cancer, lymphoma, and head and neck cancers are continuing to recruit hundreds of patients. But those
studies are all continuing in Europe. "
"We have these evolving safety concerns. They cannot be dismissed," says Harvey Luksenburg, MD, a
medical officer in the FDA's division of the****utic biological oncology products.
Experts are most concerned about a handful of large European studies showing that EPO drugs may cause
cardiovascular problems or even worsening cancers in patients on chemotherapy.
One study performed on 940 women on chemotherapy for breast cancer showed a 2.3% rate of fatal blood
clots or other fatal cardiovascular events in women taking Eprex, an EPO drug available in Europe but
not in the U.S. Women taking placebo pills had a 0.4% rate of the fatal events, nearly six times
lower. The study was planned to last a year but was stopped after just four months because of the
safety problems. "

Clinical trial in Canada with limited SCLC
http://www.bccancer.bc.ca/RES/ClinTrials/OpenTrials/VC.htm

and coincidentally today (as a result of this post), I found the following.
http://blcwebcafe.org/survivingchemo.asp
Procrit a survival risk? In a study published in the medical journal The Lancet, the epoetin group
turned out to have a 62 percent greater chance of suffering a recurrence and a 339 percent greater
chance of dying. The authors concluded that epoetin beta "corrects anemia but does not improve cancer
control or survival. Disease control might even be impaired" (Henke, Oct. 18, 2003)

Have these issues been discussed here before and concerns (if any) ruled out?
Is there an older (safety known) med (instead of Procrit) or were they less effective at treating the
low reds?
J

tony lima

Transfusion. Works. - Tony

Love & Light
Tony

tim jackson

J - I've always been worried about these drugs to boost blood cell
production. Without any contrary evidence I couldn't help feeling that this
was a "something for nothing" situation, that the increased activity had to
be at the expense of something else, and was unlikely to be doing any
favours to the patient's body. Cell production is an expensive activity in
terms of the body's resources however you do it.

Also because of their high price I can see that drug companies would want to
push them.

So I can't say I am surprised to see their overall effectiveness in
'routine' use being called into question.


Tim

because of ongoing concern that

hundreds of patients. But those


showing that EPO drugs may cause


a 2.3% rate of fatal blood

drug available in Europe but


four months because of the

and a 339 percent greater

but does not improve cancer

out?

less effective at treating the

allan_grossman

Yup. Forgot about that, Tony.

thanks -

allan_grossman

<-- snip -->

Wow. Hadn't seen that one before either - thanks for the link ;-)

akoffman

">

I can remember practicing nursing before procrit and neupogen. The
answer was to transfuse the patient. People die from blood
transfusions due to allergic reactions. Also the more transfusions
people get the more there body builds up antigens which make it
impossible to find compatible blood. Also If the patient is cured of
the cancer and later needs an unrelated transplant it becomes almost
impossible to find a match because of these antigens.
In the US there is a shortage of blood to begin with, I don't know how
available blood is in other countries.
As far as neupogen transfusing white blood cells in not a common
practice due to the fact WBC often carry diseases and viruses. In the
early days of Bone Marrow transplants patients often died from
infection. The use of Neupogen has made these treatments more
effective.

I often see surgical patients ( non cancer patients ) given procrit to
stimulate their own RBCs, if you factor in the cost of a blood
transfusion ( the cost of donation, processing , equipment, and
adminstration) I would guess procrit is cheaper in the long run.

The drug does have side effects that can't be ignored but current
medical practice is to avoid transfusions

j

I'm not sure Tim that you (and others) got the the concerns of the articles...
Chemotherapy is effective against cancer cells because the drugs love to
interfere with rapidly dividing cells. Unfortunately, cancer cells aren't the
only rapidly dividing cells in your body. The cells in your blood, mouth,
intestinal tract, nose, nails, ******, and hair are also undergoing constant,
rapid division. This means that the chemotherapy is going to affect them, too.
(that's a known)

However, from the articles (that I posted) - key sentences "Experts are most
concerned about a handful of large European studies showing that EPO drugs may
cause <snip>even worsening cancers in patients on chemotherapy.
The authors concluded that epoetin beta "<snip> Disease control might even be
impaired" (Henke, Oct.
18, 2003)

So whether or not, it's EPO (Procrit) or blood transfusion, aren't they saying
there's a concern/potential that by boosting the RBC's they're actually helping
the cancer to grow or spread or double (doubling time) by enhancing the blood
supply to it? (except for situations like carcinoma in situ where adjuvant chemo
is taken as an insurance).
J