Promacta for CLL/ITP

[Stevediam]

17p Del. On 100mg venetoclax (3rd week in the ramp up phase). Admitted to hospital with 5k plates, 7.8 hemo, 1.1 WBC on Friday, November 24th

Team stopped Venetoclax. Started me on 1000mg’s of prednisone IV (for 4 days) and 75mg of Promacta. After 4th day of high dose pred, numbers jumped a bit to: 21 plates, 9.8 hemo, 6.6 WBC.

Today is day 8. Still no Ven, tapered to 60mg oral pred and staying with the 75mg’s of promacta. This mornings labs show a slow but steady decrease in numbers: 20 plates, 9.2 hemo, 3.6 WBC.

I’m concerned the promacta is not working for me. After 7 days, based on experiences I’ve read on here, I should start seeing descent results for my platelets but it appears the only thing that helps is the high dosage of steroids which is not something sustainable due to my type 2 diabetes.

Looking for thoughts, suggestions, experiences on promacta and if I should suggest to start nplate or not?

Additionally, spleen is a little enlarged but no big difference from first CT SCAN when I was on a clinical CLL trial drug a year ago, and also currently have nothing controlling the CLL as the team is just focused on the acute issue, which is the low platelets.

Thanks for all replies

[JuciyJ]

I was admitted for low platelets and had the same treatments, prednisone, promacta and a few others. Starting each of those the hemoc dr said it would take 10-14 days to see a result. I never saw an increase until they started BR treatment.