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Medication Hold

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Hi everyone!  Happy Holidays to you all....

I have been on 100 mg Sprycel for three weeks, and due to neutropenia, I am on a medication freeze until my counts are back up.    I do have confidence in my Dr and I really like her, however I am frustrated that she started me on 100 mg.  I’m a small person who typically responds very well to medication and experience all of the side effects.  At my initial visit, I asked to be given a lower dose but was told that Dr needed to see what happened the first few months before considering a lower dose.  At the time I took that as a reasonable answer/. With the call this morning informing me that I needed to stop sprycel and continue weekly checks, I’m committed to a dose reduction before restarting.  Hopefully my doctor will agree.... I don’t want to stop taking sprycel because even on this dose with my counts so low, I feel pretty good physically. Emotionally this freeze has me pretty low because I now feel more vulnerable physically now.   I’ve read scuba’s history and it does give me great hope that this will resolve with time, but drug intolerance makes me very nervous.  Do you think that these low counts at 3 weeks is a bad sign of things to come?  When I started Sprycel my WBC count was at 81k.  

Thanks again for any advice.  My current results are pasted below. My platelets were doing great but really tanked this week.....
 

% Neutrophils
Your Value
41.3 %

Neutrophils
Your Value
0.70 THO/uL
Standard Range
1.80 - 7.50 

% Lymphocytes
Your Value
43.4 %

% Monocytes
Your Value
12.1 %

% Eosinophils
Your Value
2.3 %

% Basophils
Your Value
0.9 %

#

# Lymphocytes
Your Value
0.80 THO/uL
Standard Range
1.00 - 5.00 THO/uL

# Monocytes
Your Value
0.20 THO/uL
Standard Range
0.10 - 1.00 THO/uL

# Basophils

Your Value
0.00 THO/uL

# Eosinophils
Your Value
0.00 THO/uL

Red Blood Cells
Your Value

3.04 MIL/uL

Hemoglobin
Your Value
9.5 g/dL

Hematocrit
Your Value
28 %

RDW
Your Value
22.7 %

MCH
Your Value
31 pg

MCHC
Your Value
33 g/dL

MCV
Your Value
94 fL

Platelets
Your Value
81 THO/uL

 

 

 

 

Your Neutrophils are low, but not dangerous. You should stay off sprycel until your neutrophils rise above 1.0 - 1.2. Your red blood cells are a bit low as well, but I suspect that is your system re-balancing. You should supplement with Heme iron to help your hemoglobin levels compensate (especially true for women).

Once your blood levels rise, you should strongly urge your doctor to re-start you at 40 mg Sprycel or even 20 mg. You can always go up - but I suspect you are very responsive to sprycel. Your goal at this stage is to get acclimated to sprycel and get your normal blood system going.

What is your FISH levels (% of CML cells under the microscope that they count?)

You are going to be fine. Just need some fine tuning.

Merry Christmas!

Merry Christmas to you too!  I haven’t had a FISH test since my diagnosis one month ago, but it was 96%.   
 

Thanks for all your support and advice.  It means the world to me and my family.  

Renee