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Post Info TOPIC: How low your WBC have to be to get Neupogen shots?


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RE: How low your WBC have to be to get Neupogen shots?
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OK, so they don't count each type of WBC individually, but rather allot a percentage of the total to each, huh?  I know this one is for Neutrophils only, but I think all of the WBCs are counted that way, no?  Thank you Brad!



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Geno 1a; VL 4.7 million in Feb 2012. Started PegIntron & Ribavirin 3-9-12. Added Victrelis 4-6-12. UND since Week 8. Stopped tx Wk 23. UND 4 Wks post-tx. Relapsed 12-weeks-post.

52 y/o F, started Epclusa 11-10-19, F0/F1.  EOT 2-1-2020. UND. All liver function tests normal.



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OK, my WBC that lab was 2.1.  So 0.29 * 2.1 =  0.6.  Is that right?

What I should have done is 2.1 * 29.6 / 100 =  0.6.  Yes?  Thank you!!!   smile



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Geno 1a; VL 4.7 million in Feb 2012. Started PegIntron & Ribavirin 3-9-12. Added Victrelis 4-6-12. UND since Week 8. Stopped tx Wk 23. UND 4 Wks post-tx. Relapsed 12-weeks-post.

52 y/o F, started Epclusa 11-10-19, F0/F1.  EOT 2-1-2020. UND. All liver function tests normal.



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Multiply your 0.29 times your total WBC count that should be reported, a number like 2.4 thousand cells/microliter or 2400 cells/microliter. Those are just my numbers from my last labs.



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Geno 1A, VL 1.9 mm, SOT 12/2/11 - Pegintron/Ribavirin/Victrelis, UND since wk 8, EOT 6/15/12 (28 wks), SVR 11/30/12



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I do have all of the individual WBCs (neutros, lymphos, monos, eosos, basos) and they're all reported as "....% auto."  So I take my Neutrophil % and divide by 100?

Let me try.  Here's one:  29.6.   So that means I have 0.29 Neutrophils, Phil?  (And that sounded funny, lol)   Is that right? 



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Geno 1a; VL 4.7 million in Feb 2012. Started PegIntron & Ribavirin 3-9-12. Added Victrelis 4-6-12. UND since Week 8. Stopped tx Wk 23. UND 4 Wks post-tx. Relapsed 12-weeks-post.

52 y/o F, started Epclusa 11-10-19, F0/F1.  EOT 2-1-2020. UND. All liver function tests normal.



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Judy, They are just not reporting it, but you can calculate it:

Absolutes = WBC Count * Percentage Reported / 100

They are reporting both on mine, and the math works out. The WBC count includes neutrophils, lymphocytes, monocytes, eosinophils, and basophils.



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Geno 1A, VL 1.9 mm, SOT 12/2/11 - Pegintron/Ribavirin/Victrelis, UND since wk 8, EOT 6/15/12 (28 wks), SVR 11/30/12



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Phil - they sure do vary!  Why won't my dr ever order absolute neutrophil count?  I only saw that Once....it was on my ER Labs at hospital.  My Labs show only Neutrophils % automated count.  I'd love a little more to work with.   blankstare



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Geno 1a; VL 4.7 million in Feb 2012. Started PegIntron & Ribavirin 3-9-12. Added Victrelis 4-6-12. UND since Week 8. Stopped tx Wk 23. UND 4 Wks post-tx. Relapsed 12-weeks-post.

52 y/o F, started Epclusa 11-10-19, F0/F1.  EOT 2-1-2020. UND. All liver function tests normal.



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I think this treatment is teaching us a lot, how to read your blood test and calculate the numbers pretty well.:) 



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Geno 1b, relapsed in 2009 a week before my treatment was to be over. Started triple therapy on April 28th, 2012. UND at week 4,8,12,24,3 months post tx.



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The reported units vary. Even in the states, Quest and LabQuest don't always report the same (e.g. per microliter vs per thousand microliters). You are generally safe in converting by a factor of 10, 100, or 1000.

There should be two sets of white blood counts reported (e.g. neutrophils and absolute neutrophils).  The absolutes will be in units like cells/microliter, and the other in %. I look at the absolutes.



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Geno 1A, VL 1.9 mm, SOT 12/2/11 - Pegintron/Ribavirin/Victrelis, UND since wk 8, EOT 6/15/12 (28 wks), SVR 11/30/12



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An example (from Medicine.net):

Sample calculation of the ANC:
WBC count: 6,000 cells/mm3 of blood (6.0)
Segs: 30% of the WBCs
Bands: 3% of the WBCs
Neutrophils (segs + bands): 33% of the WBCs
ANC: 33% X 6,000 = 2,000/mm3
ANC of 2,000/mm3, by convention = 2.0
Normal range: 1.5 to 8.0 (1,500 to 8,000/mm3)
Interpretation: Normal



-- Edited by krowdog on Tuesday 12th of June 2012 05:10:24 AM

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(Geno 1a, Incivek Triple Tx, 6 month post TX - 9/20/2012 = SVR!!!)



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It really can be hard to figure with the different measures.  When I said 1.5, I was actually talking about WBCs, as a whole. 

For Neutrophils only, my lab measures normal as: 42 - 75%.  My last Neutrophil count was 29.6%

 


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Geno 1a; VL 4.7 million in Feb 2012. Started PegIntron & Ribavirin 3-9-12. Added Victrelis 4-6-12. UND since Week 8. Stopped tx Wk 23. UND 4 Wks post-tx. Relapsed 12-weeks-post.

52 y/o F, started Epclusa 11-10-19, F0/F1.  EOT 2-1-2020. UND. All liver function tests normal.

kr


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We are starting the heat of summer here in Houston 100 degrees fahrenheit - lots of humidity but I remember those days under lots of blankets in October when i started.   Keep us posted on how you are doing with the neupogen Kiwi.



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rk6 wrote:

my dr looks for absolute neutrophils less than 600

 


x

so, mine say .7,, so am i to assume that means 700..... we seem to have different measures here in nz. its hard to figure sometimes...

anyway, the lab report has all this neutropenia +++ and stuff on it... and haemoglobin dropped. no wonder i feel soooo cold. oh thats right, its the middle of winter too, with a front comin up from the south, right off antarctica. brrrrrr

 

 



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kiwi. genotype 1. started pegasus and riba on 10 nov. VL 17.6 million. (4 weeks VL 1368)  week 15 UNDETECTED... :)

kr


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my dr looks for absolute neutrophils less than 600



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LOL Kiwi!  Hang in there!  Better to be just on the edge; I'm not liking the Neupogen sx at all, ugh.  I notice some drs begin Neupogen at 2, some at 1.  Mine waitied for 1.5.

Brad - thank you!!  I am constantly searching for more precise clarification and it's not always easy to find it on the internet with lab values in a concise way.  That is a perfect explanation; I'm going to save that for my files.  Thank you!     smile



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Geno 1a; VL 4.7 million in Feb 2012. Started PegIntron & Ribavirin 3-9-12. Added Victrelis 4-6-12. UND since Week 8. Stopped tx Wk 23. UND 4 Wks post-tx. Relapsed 12-weeks-post.

52 y/o F, started Epclusa 11-10-19, F0/F1.  EOT 2-1-2020. UND. All liver function tests normal.



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yeh mine are low too. wbc are 1.8 and normal is 4-11 for a normal human. (not as low as yours renee, but i dont know if we have the same scales, not sure)

neutrophils are .7, low but not low enough. heamoglobin dropped again.

in fact im riding this whole thing right on the edge enough not to need intervention, but just enough to screw me over.

bahahaha. bloody typical kiwi. never takes the 'ordinary' path...



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kiwi. genotype 1. started pegasus and riba on 10 nov. VL 17.6 million. (4 weeks VL 1368)  week 15 UNDETECTED... :)



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LOL Thanks Brad! LOL I was actually just wondering round about how much 0.6 wbc would actually equal :) You are better at numbers than I am, especially right now lol ;)

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Genotype 1A, Genotype (from parents) CC, Viral Load=7,514,000 (as of 12/6/11) Started Triple Therapy TX: 12/17/2011.UND @ 4-48 Wks Taken Off Incivek @ 6 wks due to Rash Response. Finished TX 11/17/12. SVR year 1



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Judy S wrote:

 

WBC at 0.6 is really low, wow.  That's like having only 600 white blood cells left...

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That's cells per mililiter.

That equals 0.6 x 10 to the ninth power per a liter.(600,000,000 cells per liter)

Human averages 4.7 liters of blood =2,820,000,000 cells total.

So you are now down to just under 3 billion cells.

And amazingly, that really IS low!

(just havin' fun with numbers....guess I need to get a life ;)

Brad

 

 



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(Geno 1a, Incivek Triple Tx, 6 month post TX - 9/20/2012 = SVR!!!)



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LadyAlaise wrote:

Margo; not trying to frighten (or anyone for that matter) about the Nuepogen sides; just stating how it's been for me.
I would think (aside from the average sfx) that it might be different for each person; ie: similar to how everyone seems to react differently to Interferon.


 I know Renee, everyone is different, it's just so much people have to go through to get cured and have a normal life. 



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Geno 1b, relapsed in 2009 a week before my treatment was to be over. Started triple therapy on April 28th, 2012. UND at week 4,8,12,24,3 months post tx.



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Margo; not trying to frighten (or anyone for that matter) about the Nuepogen sides; just stating how it's been for me.
I would think (aside from the average sfx) that it might be different for each person; ie: similar to how everyone seems to react differently to Interferon.

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Genotype 1A, Genotype (from parents) CC, Viral Load=7,514,000 (as of 12/6/11) Started Triple Therapy TX: 12/17/2011.UND @ 4-48 Wks Taken Off Incivek @ 6 wks due to Rash Response. Finished TX 11/17/12. SVR year 1



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Renee - I'm laughing about the growth thing.  Yeah, like we're going through growth spurts but not getting taller, lol.  At 5'8 it's already challenging to find guys tall enough to date, particularly if I wear heels.  But heck, these days high heels and dating is the LAST thing on my mind, LOL!

WBC at 0.6 is really low, wow.  That's like having only 600 white blood cells left.  Darned ins companies!!  They couldn't care less about us, of course.  Not a great feeling to know that your dr has an even fuller caseload, now.  They're all so busy as it is.  I make lists of questions to ask my dr at each appt, as I sometimes feel rushed and forgetful.

Margo - I'm divorced for 2.5 years and live alone with my 10-year-old daughter, Brianna.  She is a WONDERFUL help with everything and I've found A LOT of support on this forum.  Who else can best relate but all of us on here, huh?  I'm so thankful for all of you.    smile

Oh!!  Last visit, my dr told me to take at least 1 mg (1,000 mcg) of Folate (Folic Acid) daily.  There's only 400 mcg in my B-100 vitamin pills, so I supplement.  He said this will increase my WBCs.



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Geno 1a; VL 4.7 million in Feb 2012. Started PegIntron & Ribavirin 3-9-12. Added Victrelis 4-6-12. UND since Week 8. Stopped tx Wk 23. UND 4 Wks post-tx. Relapsed 12-weeks-post.

52 y/o F, started Epclusa 11-10-19, F0/F1.  EOT 2-1-2020. UND. All liver function tests normal.



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I feel ya Judy! lol I would love if while on the Nuepogen (as it promotes the bone marrow to produce wbc and the bones expand), would cause me to actually grow an inch or two LOL
Hang in there!
I go for my weekly bloodwork on Mon as this thurs/friday; my ride (mom) wasn't feeling well enough to drive me. at my last bloodwork *a bit over a week and half ago?* my wbc was 0.6 so I had to take a shot of Nuepogen asap lol they are hoping I won't need to take it more than twice a month as that is all my insurance will clear; two shots a month (grumble). And to top it off my New NP (as my old one left the practice) also left this past week (lol to the same place the old one went; they both switched to Geriatrics) and now I will actually be seeing my Liver Specialist for the first time since my first appt. I am hoping this change up in their practice won't cause those they are treating problems as now the docs (all of them apparently) are having to fully cover all their caseloads.

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Genotype 1A, Genotype (from parents) CC, Viral Load=7,514,000 (as of 12/6/11) Started Triple Therapy TX: 12/17/2011.UND @ 4-48 Wks Taken Off Incivek @ 6 wks due to Rash Response. Finished TX 11/17/12. SVR year 1



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Judy S wrote:

My dr started me on Neupogen at Week 8.  My WBCs fell to 1.5.  Interesting to see the protocol the different drs have with Neupogen.  I did the injections twice weekly for first 2 weeks, then once a week.  My WBCs remain in the 2s.  My dr said he wants to see them at 2.1 - 2.9, even though 4 - 11 is normal.  He says if the WBCs are artificially raised over the 2 range, I will be more sick.

For me, there are times that the sx from Neupogen are worse than the sx from PegIntron.  Our bones expand on the Neupogen as the Neutrophils are being grown, so I get major migraines and bone pain everywhere.  Nausea, too.  Sometimes it interferes with my sleep, as well.


Oh Judy, so sorry to hear that it's so painful (:... I know how pegintron feels, can't imagine those 2 together, must be hell on earth. I hope you have help and support?

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Geno 1b, relapsed in 2009 a week before my treatment was to be over. Started triple therapy on April 28th, 2012. UND at week 4,8,12,24,3 months post tx.



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My dr started me on Neupogen at Week 8.  My WBCs fell to 1.5.  Interesting to see the protocol the different drs have with Neupogen.  I did the injections twice weekly for first 2 weeks, then once a week.  My WBCs remain in the 2s.  My dr said he wants to see them at 2.1 - 2.9, even though 4 - 11 is normal.  He says if the WBCs are artificially raised over the 2 range, I will be more sick.

For me, there are times that the sx from Neupogen are worse than the sx from PegIntron.  Our bones expand on the Neupogen as the Neutrophils are being grown, so I get major migraines and bone pain everywhere.  Nausea, too.  Sometimes it interferes with my sleep, as well.



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Geno 1a; VL 4.7 million in Feb 2012. Started PegIntron & Ribavirin 3-9-12. Added Victrelis 4-6-12. UND since Week 8. Stopped tx Wk 23. UND 4 Wks post-tx. Relapsed 12-weeks-post.

52 y/o F, started Epclusa 11-10-19, F0/F1.  EOT 2-1-2020. UND. All liver function tests normal.



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I have found the neupergin and procrit treatments vary wildly. I've been on neupergin twice a week FOREVER. In fact since i get my blood drawn almost every week and the nurses have not called AND my blood work is nearly normal I stopped taking the procrit and cut the neupergin to once a week. my labs havent changed that much. I would never mess with the treatment regamine but this other stuff... Some are not getting it and others are on it for the duration. Makes it hard to tell how important it really is. Think I'm getting a little crazy... Nevermind going to bed.

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Kelly 2b dx 8/11. Tx begun 12/30/11. Apparently had it for decades.


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LOL JoAnne :) I get that lol at this point I just usually try to remember the pics lol :)
Name's Renee



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Genotype 1A, Genotype (from parents) CC, Viral Load=7,514,000 (as of 12/6/11) Started Triple Therapy TX: 12/17/2011.UND @ 4-48 Wks Taken Off Incivek @ 6 wks due to Rash Response. Finished TX 11/17/12. SVR year 1



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RK6 and Lady Alaise, thanks for the honesty and hope I don't need it!
Also w Brain fog real names to go w pictures would be easier:) just saying...;)
Appreciate this formun
JoAnne

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Genotype 1a, Triple therapy w/Invicek started May 19, 2012

DET 4 wk. UND 2,6,12,24 48 treatment. Achieved SVR 2013!



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Wow I didn't think it's that bad...just ads another kick to the interferon. I cant imagine how you can function after this. I guess my tests are not that bad compare to you guys, you make me feel like I have no side effects at all. I hope you can feel better, just keep in mind that it's temporary. Brain fog, forget it. What was I talking about again?

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Geno 1b, relapsed in 2009 a week before my treatment was to be over. Started triple therapy on April 28th, 2012. UND at week 4,8,12,24,3 months post tx.

kr


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THey are looking for absolute neutrophils in the 600 or so range and then I get the word to do the neupogen.   Hate to make anyone worried but the neupogen sides (as described by LadyAlaise) are some of the worst for me - doing my shot in an hour or so and will be in bed tomorrow



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I am in week (24?25?) LOL hard to keep track at this point-I have taken two shots total for nupogen over the last 4 weeks;
the first week I took it my WBC was below 1.7
this past week i took it my WBC was 0.6
Side effects I have gotten from Nupogen:
1. It burns & hurts like hell (for me) to inject. (pain and burning go away within an hour)
2. All my Lymph Nodes swelled up and those sites were VERY tender and my body was tender and achey.
3. Fevers (Hard to tell if it is nupogen or just tx; been having fevers & chills through the whole thing)
4. BONE PAIN (omg) didn't get the bone pain til the second shot. (like growing pains on steriods lol)
I have my WBC count done weekly so they can call and tell me wether or not to take a shot of Nupogen.
Haven't been put on Procrit.
-
I am not 'too anemic' according to my NP (been that way for most of tx)
---
Aside from this brain fog is now a MAJOR problem for me; I am forgetting simple things (or even what week I am on w/Interferon lol)
I am very weak and tired, nor am I getting much sleep.

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Genotype 1A, Genotype (from parents) CC, Viral Load=7,514,000 (as of 12/6/11) Started Triple Therapy TX: 12/17/2011.UND @ 4-48 Wks Taken Off Incivek @ 6 wks due to Rash Response. Finished TX 11/17/12. SVR year 1



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rk6 wrote:

I think my NP looks at absolute neutrophils which she says they are looking to be above 600.  I am on week 34 of 48 Victrelis and doing both procrit and neupogen but not every week.  I get CBC bloodwork every week and then they tell me which rescue drugs to do.   This week I did neupogen last night.   For me I don't like the sides on neupogen - fever, some nausea, muscle aches etc and sometimes insomnia but I slept well last night and another 4 hours this am.    I have been a lot more tired lately even though I'm not as anemic.  guess the drugs are catching up


 Hi, Ive heard about Neupogen side effects...hang on, its almost over. There are natural WBC boosters you know? I posted the article under knowledge info. Feel better, thanks for your response.



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Geno 1b, relapsed in 2009 a week before my treatment was to be over. Started triple therapy on April 28th, 2012. UND at week 4,8,12,24,3 months post tx.

kr


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I think my NP looks at absolute neutrophils which she says they are looking to be above 600.  I am on week 34 of 48 Victrelis and doing both procrit and neupogen but not every week.  I get CBC bloodwork every week and then they tell me which rescue drugs to do.   This week I did neupogen last night.   For me I don't like the sides on neupogen - fever, some nausea, muscle aches etc and sometimes insomnia but I slept well last night and another 4 hours this am.    I have been a lot more tired lately even though I'm not as anemic.  guess the drugs are catching up



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Phil G wrote:

I was at both 2.3 and 1.1 at the end of week 9. I am doing Victrelis, so that's only a couple weeks on the 3rd drug. So yours looks pretty normal to me. The next week, mine were 2.9 and 1.8. My white blood stuff has never established a clear trend, kinda up and down, unlike the red, which all went down steadily until my riba was reduced. The info I have is that peg may be reduced or other drugs added at WBC 1.5 and neutrophils 0.75.



-- Edited by Phil G on Saturday 2nd of June 2012 07:32:50 PM

Thanks Phil!

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elizabeth wrote:

Anxiously awaiting someone's response to this as I've been wondering what neutrophils are. I see nothing on any of my husband's lab reports that refer to neutrophils. His WBC is down to 1.8 as of Thursday's labs.

And thanks to everyone on this forum. I honestly don't know what I would do without all of you!


Neutrophils are white blood cells that injest bacteria And they are First immune cells to arrive at the site of infection. Low neutrophils cause compromised immune system and can be very dangerous. Btw I found some info online to boost WBC naturally and I posted it in the knowledge topic. I ordered the vitamins today for myself.

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Anxiously awaiting someone's response to this as I've been wondering what neutrophils are. I see nothing on any of my husband's lab reports that refer to neutrophils. His WBC is down to 1.8 as of Thursday's labs.

And thanks to everyone on this forum. I honestly don't know what I would do without all of you!

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I'm thrilled of being UND at week 4! However, my WBC are 2.3 and Absolute Neutrophils are 1.1. My doctor didn't say anything to worry yet, just wanted to know what is considered to be low and what are the steps?

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Geno 1b, relapsed in 2009 a week before my treatment was to be over. Started triple therapy on April 28th, 2012. UND at week 4,8,12,24,3 months post tx.



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I was at both 2.3 and 1.1 at the end of week 9. I am doing Victrelis, so that's only a couple weeks on the 3rd drug. So yours looks pretty normal to me. The next week, mine were 2.9 and 1.8. My white blood stuff has never established a clear trend, kinda up and down, unlike the red, which all went down steadily until my riba was reduced. The info I have is that peg may be reduced or other drugs added at WBC 1.5 and neutrophils 0.75.



-- Edited by Phil G on Saturday 2nd of June 2012 07:32:50 PM

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Geno 1A, VL 1.9 mm, SOT 12/2/11 - Pegintron/Ribavirin/Victrelis, UND since wk 8, EOT 6/15/12 (28 wks), SVR 11/30/12

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