Anemia

[Blair77]

In preparation for LU 177 Mike came off his chemo regimen. His platelets rose from 50,000 to 80,000 and his wbc from 3.4 to 6.4. However his RBC(3.4-2.9)and hgb( 10.1 to 9.6) both dropped. I’m confused as why one group of blood counts would rebound and move in a positive direction but the other group looks worse. Any ideas?

[Tall_Allen]

Those are small changes - maybe just a lag. What did his doctor say? How are his other indicators- ferritin? Iron? B-12? Liver enzymes? Folate? Kidney function?

[Blair77 in reply to Tall_Allen]

They only ran the CBC.

[Tall_Allen in reply to Blair77]

What did the oncologist say when youu asked him?

[Blair77 in reply to Tall_Allen]

Just got the results last night so no word.

[tom67inMA]

I'm curious as to what other people say, because I'm the opposite way. HGB has been recovering after chemo, but platelets and white counts have been sagging a bit below normal.

Perhaps when the marrow can't make sufficient quantities of everything it picks a favorite? That's a horrible explanation so I hope somebody else has a better one

[EdBar in reply to tom67inMA]

I had chemo per CHAARTED five years ago and my WBC still falls to below normal levels on a regular basis. Even when WBC is normal it’s a low normal. MO says it’s due to chemo and marrow may never fully recover. It’s one of the long lasting, maybe permanent SE’s of chemo that I have.

RBC and HGB were below normal too until I started taking iron supplements per my MO now they are back to normal. I get my iron levels tested regularly while taking them, it’s important that they don’t get too high. I’ve been on ADT for close to six years now and that is likely the reason for the anemia.

Ed

[JDKotter in reply to EdBar]

EdBar, what do you take to prevent constipation from taking iron supplements?

[EdBar in reply to JDKotter]

No problem with that.

[RICH22]

I was dx with MDS - a few different kinds but I have the one that is caused by broken DNA, so my HGB and RBC are messed up but my platelets and WBC are fine. May want to get a bone marrow biopsy.

[MateoBeach]

There may be some cues in the indices and morphology aspects of the CBC. Low MCV and MCHC suggest iron deficiency. High MCV may be related to B12 / folate deficiency. Reticulocyte count reflect newer RBC production. The tests Tall Allen suggested are wise.

[MateoBeach]

. . and ferritin levels nicely reflect total body iron stores.