ANC is zero

[yellowgreentc]

My ANC went from 2.1 May 15 to .2 last Friday. Tested again today and it is zero. I'm on imbruvica and have rituxan infusions 1x per month. They wouldn't give me my infusion last Friday because of the low ANC and told me to stop taking imbruvica. I go back Friday to see what they're going to do with me. I'm really bummed because imbruvica was making me feel so much better. Anyone else have this issue?

[PlanetaryKim]

My ANC has never gone right down to zero, but has certainly gone down to 0.2. It's a bad scene. In my case, drugs stopped each time that has happened. Neutrophils have bounced back (or bounced back enough) and drugs resumed. Good luck to you!

[Hidden]

i suspect your rituxan infusions are more responsible. Imbruvica on it's own rarelly gets anyone really low wbc.

Now that i;ve said that there will be many posts saying we'll it did for me.

[alpek]

This has happened to my dad who is a trial combining Ibrutinib/Venetoclax/Obinutuzumab, neutrophils went from ~2 to 0 in two weeks, treatment was held for ~3 weeks until they recovered to over 1.5 ANC. Some members have had G-CSF administered to boost ANC while in other cases a treatment hold/recovery without G-CSF is common.

[AussieNeil Partner Administrator]

Time to (hopefully temporarily) adopt a neutropenic lifestyle and stay safe until your neutrophils recover: healthunlocked.com/cllsuppo...

When your bone marrow has totally ceased making neutrophils, it takes 10 days after the bone marrow recovers enough to make new neutrophils before they have matured enough to be released into your blood stream. G-CSF may be needed to kick-start your bone marrow.

Neil

[LynnB1947]

Started treatment of rituxan & ibrutinib in 2014. After 3 months, my neutrophils were below 0.6. I got 3 neupogen injections to boost the system & counts came back up. Blood counts have been good ever since. April 2020 marked my 6th anniversary on ibrutinib. Wishing you the best ... LynnB

[yellowgreentc in reply to LynnB1947]

Thank you. It looks like they're going to be giving me those shots. How are they and how long did you have to wait to resume imbruvica and rituxan?

[Smakwater]

yellowgreentc,

When I became neutropenic during treatment on both Gazyva and Venetoclax, I was given a G-csf which raised my neutrophils enough to have the last infusion of Gazyva, which is also a CD20 monoclonal antibody as is Retuxan.

To my surprise this raised my ANC to 6.8 in less than 24 hrs. I received the last infusion that day following the G-csf and it was of no consequence. The increase in neutrophils remained acceptable for a little over two months while I continued venetoclax.

I am sure that every case of neutropenia must be addressed individually. Stressing the marrow to produce neutrophils with G-csf during treatment is a serious decision, and I did not discuss with my physician the reason he felt the importance to administer the drug at the time. I assumed that it was because it was a requirement of the trial criteria.

Hope you get back on track and enjoy a full and durable response.

JM

[yellowgreentc in reply to Smakwater]

Thanks for your response. I hope my ANC responds as quickly as your did!

[Smakwater in reply to yellowgreentc]

My ANC responded initially allowing me to continue treatment. The 6.8 became 1.5 in two months and fell below 1 shortly after that. Three months later and just prior to discontinuing venetoclax it climbed to 1.8. I am now 5 1/2 months post treatment and the ANC is still 1.8.

WBC is around 3.8, monocytes are at 12?, everything else is in range.

I am not sure the analytics will change the destined outcome, however; when the day allows a higher quality of life, I'm on it!

All the Best yellowgreentc

[IRN83]

I have been fighting CLL for 12 years, with four different chemo cocktails. This has happened to me numerous times. But with a good medical team and wisdom to stay away from everyone you can, your body will recover. I think the others have commented on what was done to boost their ANC levels so I won’t add to that. The first time this happened to me the nurse grabbed me and put me in isolation and told me you could get sick right now and die! It can be a serious condition. So don’t take it lightly but don’t panic either. Praying you get well soon.

[yellowgreentc in reply to IRN83]

Thank you and sorry to hear it's happened to you numerous times. I've been staying home. It's just me and my spouse so he runs all the errands. I'm pretty fortunate.