Blood work insight needed.

[Gradyboy]

I'm a couple days in on full dose Venclexta with no side effects, but my cbc after day one of 400ml was a bit out of wack. WBC a tiny bit low, lymphocytes a little high and leukocytes a little low. Absolute numbers still in normal range and platelets at 277. I'm guessing these numbers are more reflective of the 200ml that I just finished only had one dose of 400 before blood work. Should I expect even worse numbers next week? Before the 200 ml week my numbers were all in normal range. Im a little worried. Any advice from the more experienced?

[lankisterguy Volunteer]

Hi Gradyboy,

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Below are my white cell counts graphed from when I started Venetoclax in 2016 until today. I think you can see that they bounce around once you reach 400mg dose.

The primary thing that will get your CLL expert concerned is if your ANC / Neut# goes below 1.0 and if you reach 0.5 they may act quickly.

Your ALC/Lymph# will likely stay low and possibly dip below 1.0, but that won't raise any alarm.

Hopefully your platelets will stay above 150, the docs may react if it drops below 100.

We hope you will achieve our goal of being a boring patient for your CLL expert.

Len

White Cell graphs 2016 to current

[Gradyboy in reply to lankisterguy]

Thank you! That helps. I haven't talked to Dr about what they are looking for on these weekly test.

[SofiaDeo]

Leukocyte count = WBC. Leukocyte is another name for white blood cell, are you meaning to say lymphocyte (subset of all leukocytes/WBC's)? Your doc will likely be looking specifically at lymphocytes and neutrophils, not your total WBC. It's possible for lymphs to jag up & down a bit and the docs don't care. They DO care how the neutrophils, specifically, act. The drug is potentially adjusted based on how neutrophils, platelets, and RBC's react, but not any of the others.

[Gradyboy in reply to SofiaDeo]

Yes that is what I meant. Thank you for catching.

[SofiaDeo in reply to Gradyboy]

If you are interested, I charted a bunch of labs when I did my Venclexta induction: healthunlocked.com/cllsuppo...

Others have put stuff in their profiles, or did Venclexta induction posts.

[Gradyboy in reply to SofiaDeo]

Thank you so much.

[IRN83]

My experience is that Your numbers will definitely start changing with the treatment because that is what the drug does. It will take months for the numbers to reach a new normal for you.

I’ve been treated with V&O twice now in the past four years (only 2 years of remission between treatments).

The first time I had a very bad reaction to the treatment after the rampup to 400mg. I spent two weeks in the hospital with severe pneumonia and sepsis . Then went from 400 mg to 100 mg and was in remission in 5 months. My numbers were all over the chart for a while then stabilized as the cancer was eradicated from my Bone Marrow.

I have been on V&O again now, at 400mg, for almost a year. In the first seven months of treatment there were no signs the treatment was working at all. WBC and ANC were below 1.0. So, I had two Neulasta shots to boost my immunity. My platelets dropped to the low 30s. Now all of my numbers are finally starting to go back into the normal range again.

But I can say that the V&O treatment has worked for me and it was the easiest treatment I’ve had (I’ve had 6 months of FCR, 9 months of BR, a year of Ibrutnib and now two treatments of V&O).

I’m still here enjoying life! I’m thankful for the progress the medical profession has made over the years that has kept me alive.

[Gradyboy]

Thank you. The treatment has been so easy so far. I just panic about everything lately. My poor husband has probably had it with me. LOL