Hello,
My mother was recently diagnosed with CML. She was started on Gleevec about four weeks. Her WBC was about 80k to start with. As of this week, her WBC is around 1,000 and the doctor is a little concerned. He took her off of the Gleevec and is ordering some neopogen injections. My question is whether or not a low WBC is normal in the initial stages of taking Gleevec and whether or not I should be worried. Thanks for your help!
Sandy's reply to the query above sets out a very good explanation of why low white counts happen on Glivec and that it is very common in early treatment - there is nothing untoward here but it is a careful balancing act because if the white cells drop too low this leaves the individual more vulnerable to infection, which is what you don't want. When white counts are low you do need to be more aware of infections than normal and consult the hospital if your mum develops a temperature etc. The neupogen will improve the white count in a matter of days.
I just thought I'd give you some info on my case which may be useful background for you. I had 400k white count at diagnosis (very high!) and on starting Glivec the white cells plummeted so I was put on neupogen which had a pretty immediate effect and actually in my case meant I was able to continue with the Glivec throughout. From experience there is some fine tuning with the Neupogen as to how often you need to take it depending on the impact on the white cell count. I actually stayed on the neupogen injections for a year which is way longer than most people and then slowly the healthy white cells began to hold their own and I didn't need it any more. My time period on Neupogen may have been particularly long because I did remain on Glivec throughout - I learned to self inject after a while which was more efficient than a trudge to the hospital.
Anyway, as some comfort to you and your mum, that was all 11 years ago and I have remained fit and well on Glivec all that time ( and even very recently reduced the dose from 400 to 200g daily).
It sounds like the consultant is doing all the right things here. You are also asking lots of very sensible questions to keep yourself well informed.
Do let us know how your mum gets on.
All the best
Annie
Hi, Annie,
Thank you so much for your response. Your testimony and reassuring words have comforted me and my mother immensely. She has been experiencing some fatigue lately, which also has me a little concerned, but we are assuming that is a response to the low WBC. Praise God that you are healthy and happy 11 years later. I am sure my mother will be back to normal in no time. Thank you again for sharing your story and helping me have some peace.
Anthony
Sorry for slow reply - white counts came up quickly on neupogen - within a week I'd say (although this was 11 years ago and , happily, a distant memory!) I am sure your mum's white counts will improve very soon and if she is going to the hospital/clinic every few days for injections they will be keeping an eye on all her other blood counts too, which should be reassuring. Let us know how she gets on tomorrow.
Annie
