Low hemoglobin & Platelets - Xofigo

[Nickhmcg]

Low hemoglobin - Hi all, my Dad had his last infusion of Xofigo (radium 223) on December 23rd. He needed 1 blood transfusion prior to this and then again the following week (Jan 4th, his levels were hemoglobin 8 platelets 55). He had his Zometa the same day as the last blood transfusion and while he does tend to suffer with pain flare up to 7/8 days post zometa - this month though his pain was very bad, they had to increase his Oxycontin & oxynorm.

Today he had his bloods drawn and his hemoglobin is 7.3 and platelets 53 so both have decreased. He is on a phase 3 trial (Peace 3) with Xofigo /xtandi & zometa. They are bringing him in to give him possibleh 2 units of blood this time to try and boost him. Has anyone experience with levels reducing to this rate with Xofigo?

They didn't give him his PSA levels but it had been increasing, but scans stable.

Many thanks in advance as always 🤗

[Hidden]

Bone marrow suppression can occur with Xofigo, but it's not that common. Best to look at the clinicial trial data involving many patients:

From the prescribing sheet:

accessdata.fda.gov/drugsatf...

5.1 Bone Marrow Suppression

In the randomized trial, 2% of patients on the Xofigo arm experienced bone marrow failure or ongoing pancytopenia compared to no patients treated with placebo. There were two deaths due to bone marrow failure and for 7 of 13 patients treated with Xofigo, bone marrow failure was ongoing at the time of death. Among the 13 patients who experienced bone marrow failure, 54% required blood transfusions. Four percent (4%) of patients on the Xofigo arm and 2% on the placebo arm permanently discontinued therapy due to bone marrow suppression.

Another possibility is that he has bone marrow intrusion. That's when the cancer gets into the bone marrow and interferes with the production of blood cells.

Things to discuss with his doctor.

[Nickhmcg in reply to Hidden]

Thank you for responding, I'm hoping it's just a matter of boosting him with another transfusion and his levels will stabilise but I will absolutely take onboard your advice thank u again

[Hidden in reply to Nickhmcg]

I would think that if it's being caused by the Xofigo, the counts should stabilize and then improve.

[Magnus1964]

He should have received iron infusions before the trial to bring his hemoglobin up to par.