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Hep C Discussion Forum -> On Treatment -> low wbcs on solvadi peg n rib they want mw to decrease
Post Info TOPIC: low wbcs on solvadi peg n rib they want mw to decrease
libgirl07


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RE: low wbcs on solvadi peg n rib they want mw to decrease
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I just left her a message questioning the use of neupogen. We shall see. 



__________________

Genotype 1a

1/18/13 -  VL 1.5mil triple therapy with boceprevir

2/3/14 - relapsed. 1.7ml

 

6/28/14 - started solvadi interferon and ribavirin for 12 weeks

7/28/14 - week 4 undetected dosage reduction of rib and peg

 

11/2/14 und 4 weeks post eot

 

g

 
Tig


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I'm curious why the consideration for Neupogen or a blood transfusion hasn't been considered Libgirl? They provide a rapid increase in blood counts without the need for Interferon reduction. 

Tig

 



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Tig

68yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 9+ years!

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libgirl07


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Now she wants me to stop interferon all together until my white blood cells and neut goes up. She was pretty much saying I'm not tolerating interferon this time and I might stop and wait for the new drugs in October.

__________________

Genotype 1a

1/18/13 -  VL 1.5mil triple therapy with boceprevir

2/3/14 - relapsed. 1.7ml

 

6/28/14 - started solvadi interferon and ribavirin for 12 weeks

7/28/14 - week 4 undetected dosage reduction of rib and peg

 

11/2/14 und 4 weeks post eot

 

g

 
libgirl07


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Posts: 165
Date:
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Thank u taz u have given me hope. 



__________________

Genotype 1a

1/18/13 -  VL 1.5mil triple therapy with boceprevir

2/3/14 - relapsed. 1.7ml

 

6/28/14 - started solvadi interferon and ribavirin for 12 weeks

7/28/14 - week 4 undetected dosage reduction of rib and peg

 

11/2/14 und 4 weeks post eot

 

g

 
TazKat


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Date:
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on sovaldi (just finished treatment 7/17) my riba was losered this treatment to 3 a day instead of the 6 a day i did with incivek. They even took me off for 6 days in the beginning because i was having a reaction. skin & nerves. lol  but all did good. i am cleared & will know by oct 24 if i am svr.. 

smile



__________________

TazKat Genotype 1A null responder x 3 riba & iterferon twice, relapsed from Incivek 2012 with only 12 weeks left to do. stage 4 mild cirrhosis 4/25/2014/ started sovaldi riba & interferon.. finished treatment 7/17/14  results 7/25  cleared..

 

 
Isiscat2011


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libgirl07 wrote:

I meet with her tomorrow morning. I'm going to ask her the statistics then. 

She won't have any.  Certainly nothing reliable or definitive that you can take to the bank.   I'd use the time to ask her the real question:  What are my options?   smile   

This may sound cynical but lowering dosages is faster and easier than getting insurance approval for medical alternatives (if they are even necessary at this point). Unfortunately, the easier road is the one some health care providers travel on.  If you are being treated by a nurse practitioner ask to talk to the doctor. 



__________________

Diagnosed in 2011, Incivek triple in 2011, tx discontinued, Genotype 1a, CT, VL 7mill, cirrhosis dx in 2012, age 67, waiting for new DAAs.
libgirl07


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I meet with her tomorrow morning. I'm going to ask her the statistics then. 



__________________

Genotype 1a

1/18/13 -  VL 1.5mil triple therapy with boceprevir

2/3/14 - relapsed. 1.7ml

 

6/28/14 - started solvadi interferon and ribavirin for 12 weeks

7/28/14 - week 4 undetected dosage reduction of rib and peg

 

11/2/14 und 4 weeks post eot

 

g

 
Isiscat2011


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Posts: 1724
Date:
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libgirl07 wrote:

I had a blister that the doctor swabbed and it tested positive doe mrsa. I think I that is the only reason I am fearful. My immune system not being able to fight that off. But I want to SVR but jeez haha. I can't find anything on SVR rates in reduction in meds for solvadi. 

 Hi libgirl:

Well, the reduction would not be of Sovaldi, it would be of Int/Riba.  I don't think it is safe to assume that Sovaldi is so good it can overcome Int/Riba dose reductions.  If it was that good it could be used as monotherapy.  

There is a general rule with drug dosages that if you go below 80% of the recommended dosage it will reduce efficacy.  Like everything else it depends on the individual --some may need 100% while others may get by with 60% and it depends on timing as well--so many variables.  Keep in mind that Interferon is actually boosting your immune system.  Gotta do what your doc says but sometimes they forget to discuss alternatives and we need to know all of our options to make informed choices.     



__________________

Diagnosed in 2011, Incivek triple in 2011, tx discontinued, Genotype 1a, CT, VL 7mill, cirrhosis dx in 2012, age 67, waiting for new DAAs.
libgirl07


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I had a blister that the doctor swabbed and it tested positive doe mrsa. I think I that is the only reason I am fearful. My immune system not being able to fight that off. But I want to SVR but jeez haha. I can't find anything on SVR rates in reduction in meds for solvadi. 



__________________

Genotype 1a

1/18/13 -  VL 1.5mil triple therapy with boceprevir

2/3/14 - relapsed. 1.7ml

 

6/28/14 - started solvadi interferon and ribavirin for 12 weeks

7/28/14 - week 4 undetected dosage reduction of rib and peg

 

11/2/14 und 4 weeks post eot

 

g

 
Scruffy


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Hiya Nicole

I can understand you not wanting to lower your dose. I was on epogen for 40 out of the 48 weeks and they had to add neupogen too for the last 12 weeks all not to lower my doses. Maybe with the new meds its ok?? Have a good talk with your doctor.

Good luck to you.



__________________

Geno 1a null responder 2004 inter/riba   finished incivek,peg/riba 48 weeks May 17th 2014. undetect weeks 4-12-32.  EOT+7 undetect. EOT+24 SVR!!!!! EOT+!YEAR SVR!!!!
mallani


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Hi Nicole,

The ANC (Absolute Neutrophil Count) is more useful than the WCC.  Mine dropped to 0.7 but there was no way I was getting a dose reduction.

The decreased ANC is due to Interferon- there's no justification for reducing Riba. With your history of relapse on the Victrelis, there's a question mark over your Interferon sensitivity and I wouldn't want to lower the dose of Peg. You're only on 12 weeks of Sovaldi triple, so ask why she's worried. Perhaps Neupogen is an option.

You must be guided by your doctor, but it's OK to ask questions. Good luck.



__________________

Geno 1b, IL28B CT,  x3 prior relapser,  ex-cirrhotic, 75 yo, did 48 weeks with Victrelis/Peg./Riba.  VL 1.28m at start, UNDET. at 8 ,12 ,16 ,24 ,30  and 48 weeks.  EOT 15 Feb 2013 , UNDET. at EOT + 28 weeks. SVR!  Still Undet. at EOT +5 years

Malcolm
libgirl07


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She said because my neut and wbcs are low.  I go talk to her Wednesday I'm going to just continue my rib like normal I guess until I actually get to speak to her myself. I also had a blister swabbed and it was positive for mrsa so perhaps that's also why. 



__________________

Genotype 1a

1/18/13 -  VL 1.5mil triple therapy with boceprevir

2/3/14 - relapsed. 1.7ml

 

6/28/14 - started solvadi interferon and ribavirin for 12 weeks

7/28/14 - week 4 undetected dosage reduction of rib and peg

 

11/2/14 und 4 weeks post eot

 

g

 
Isiscat2011


Guru

Status: Offline
Posts: 1724
Date:
Permalink  
 

I appreciate your concerns.  Dose reductions can make a difference in outcome, no matter what they say to make you feel better about it, and some docs are perhaps too quick to reduce doses.  

My doc looked at absolute neutrophils (ANC) in addition to wbcs for a better indicator.  Malcolm is the person to tackle this but it might help to provide the ANC number as well.  

 



__________________

Diagnosed in 2011, Incivek triple in 2011, tx discontinued, Genotype 1a, CT, VL 7mill, cirrhosis dx in 2012, age 67, waiting for new DAAs.
Hope4


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Afraid I have no  information for you about the proposed decreases.   Did they say if it would just be a temporary adjustment, for a week or so?  I'm starting the same treatment on Thursday this week so I just wanted to check in with you, say hello and I'll be following your updates.  Wishing you the best. 

 



__________________

Gen 1a        60 yrs     (was tx naive )   Started tx Pegasys, Ribavirin and Sovaldi on 7/31/14  12 wks.    VL 2,186,415.      Dr. said no cirrhosis, had no biopsy. EOT 10/22/14, undetected.  TX was tolerable, overall.

Still Undetected 4/27/15   SVR 24!!!
libgirl07


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Date:
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My 4 week labs aren't bad but my wbcs dropped to 1.54.  My doc wants me to lower interferon to 140mcg and go from 3 rib in am n 2 at night to 2 in am 2 at night.  I'm scared to lower my dosages. I relapsed last time on beceprevir lowering my rib.  Anyone have any input please 



__________________

Genotype 1a

1/18/13 -  VL 1.5mil triple therapy with boceprevir

2/3/14 - relapsed. 1.7ml

 

6/28/14 - started solvadi interferon and ribavirin for 12 weeks

7/28/14 - week 4 undetected dosage reduction of rib and peg

 

11/2/14 und 4 weeks post eot

 

g

 
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