After Regeneron Drop In Neutrophils? Did I make a mistake?

[PalmettoMiami]

Update. Husband had 5 months of Gazyva/Venclexta. Had gotten up to 400 mg. of Venclexta when neutrophils started dropping too low. Twice had to hold and get GSF. First time resumed Venclexta at 200 mg. Had to stop again and get injections again but then resumed at 100 mg. at my request, but neutrophils remained low. Finally agreed he would stop all treatment for now. All red counts very good, hemoglobin 14.5, RBC normal, etc. 11 days ago after exposure to daughter in law who tested positive for Covid 2 days later, I took him for subcutaneous Regeneron as a prophylactic knowing the vaccines probably didn't have much effect. Thankfully he did not get Covid but last week neutrophils dipped to 1.4 but today they were .11! He has been off all treatment for 3 weeks.

The oncology nurse still wonders if the Regeneron could have caused this. Now doctor wants to do a bone marrow biopsy. He always wants these and I always resist. Why a BMB when all red counts are completely normal? It seems obvious to me it was iatrogenic because of treatment. Had GSF injections today and scheduled through the weekend for 3 more. Any thoughts? Also has anyone ever had this low of neutrophils without any issues? We still shelter except for hospital visits. Thanks all for listening.

[AussieNeil Partner Administrator]

A bone marrow biopsy is the best way to investigate the cause of any abnormal blood cell count if the cause can't be determined by peripheral blood tests. It gives you a sample of your blood cell production factory, whereby it is possible to see how each blood cell type is progressing through the stages from creation to maturation and final release into the peripheral blood.

We've had members report lower neutrophil counts without problems, but obviously you'll need to be on alert for infections and febrile neutropenia. Hopefully those frequent G-CSF shots will do the trick!

Neil

[kathymac5252 in reply to AussieNeil]

My husband has had months of neutropenia ( he is on V and O) finished Obinituzimab in November. Just had bone marrow biopsy and we are waiting on results. He also had a CT scan as he has been on Veneteclax for almost year. Despite Granix shots, his WBC and Neutrophils have not risen. He is severely neutropenic with neutrophils at .2 and WBC at 1.2. His platelets are very low at 46, and RBC and hemoglobin are below normal We have to avoid crowds ( me too), wear masks constantly, and only associate with those who have been vaccinated. We have a video conference on Tuesday with our oncologist so we will know more. We did see he has 56% lymphyctyes in his bone marrow....so we know this is too high. Feeling a bit discouraged....He takes Acyclovir and Bactrim to combat infection. So far he has avoided infection.