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Low platelets

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Hello
I am a 10 years cml patient,being on 400mg imatinib, my pcr is under control log reduction is >3
About 9 months my platelets started to decrease,it is not a dramatical decrease it was around (134-139) the last test it was 111, i got a bit nervous,,i am taking a monthly shot of b12 so it is stable,iron and ferritin is within the range.
My oncologist said if it decreases more i have to make a bone marrow biopsy to make sure there is no issue with it (other blood cancer one of the options)
She said she is not concerned yet,,but i am 😅
Could it be because of the medication?

My wbc is 3, hemoglobin around 12.
I need your opinion please.
Thank you

Hi Iffat,

Low platelets (and low blood counts, in general) can be caused by our medications, yes - absolutely.

You do often find these things go up and down, so you might find your next test that they improve a bit.

A bone marrow biopsy is very useful for a doctor, but it’s not without pain for the patient. I wonder could you discuss dropping your dose of imatinib to 300mg. This is done routinely when side effects are evident, but disease response is also good (like yours). Often just reducing the dose by that amount is enough to help with things like low blood counts.

David.

Hello
Thank you for your response,actually yes i did a new blood test few days ago and it improved a bit.
I tried once before taking 300 mg because i had eye bleeds but i lost my MMR so got back to 400 mg again..since then my platelets kept dropping low (still above 100) hopefully next test will be better..
I feel much better now ,thank you

I’m pleased to hear that, and that you are feeling better!

If things don’t resolve nicely for you, do you have the option of switching to a different TKI?

David.

We didnt discuss this option yet and she said she is not concerned yet as long as they keep being above 100,,
I will ask her next appointment if we can do that.
Thank you.