Is Allopurinol not needed for continuing treatment with FCR if the WBC is 2.0?

[keepfit123]

[Cllcanada Top Poster CURE Hero]

Allopurinol is a drug used primarily to treat hyperuricemia (excess uric acid in blood plasma).

When white blood cells die, lyse, they spill out thier contents, raising levels of uric acid in the blood.

In my case they stopped using it during treatment, after my absolute lymphocyte count (ALC) got below 30K, so this sounds reasonable... however kidney function may be a factor...

Check with your doctor for clariication.

[Oleboyredw-uk]

I had Allopurinol in first FCR cycle only. My WBC had dropped back into normal range by end of first cycle.

Rob

[David39]

Hello keepfit123, how are you getting on with your treatment? My experience is similar to Cllcanada's - the Allopurinol was discontinued after the initial large drop in WBC had taken place.

[keepfit123 in reply to David39]

I am just into my third cycle of FCR. My blood results just before this were WBC 2.0, RBC 2.5, Platelets 164, Haemoglobin 8.3, ANC 1.0, ALC 0.5. ( hopefully these will improve) . Liver and kidney function tests were normal this time. It was only on my querying of the need for the Allopurinol that the Senior Nurse Specialist withdrew it from the bag of tablets that I was given!! I am still on half the recommended doses of Fludarabine and Cyclophosphamide no doubt because the counts have come down and improvement of the lymph nodes around my jaw and neck, although I can't help thinking it's the Rituximab that's done the heavy lifting. My concern at present is the slightly swollen ankles and feet that seem to come on more towards evening time...any ideas? Could it be all the water I am drinking with all the tablets?

Cheers, keepfit123

[MsLockYourPosts Passed Volunteer]

It could be all of the water, but I would make sure your kidney values are being monitored closely. Edema can also be the result of some cardiac issues. A check with a cardiologist might be a good idea if your hematologist has no explanation. I was recently diagnosed with venous insufficiency, which shows up on ultrasound. It is a third possibility. While this probably relates to your treatment, it is important to remember that not every medical issue is caused by our CLL.

[jangreen]

I stopped taking allopurinal after the first cycle because of a reaction to it but my kidneys are fine. I do now, after treatment, have a small amount of swelling at my ankles but GP says not bad enough for water tablets. I do try to drink a lot of water during the day and excise my ankles which helps.

[keepfit123]

Regarding the build up of fluid in my feet and ankles my doctor checked my heart, blood pressure examined my feet and concluded I did not need water tablets. He said it was a matter of circulation due to age and a few varicose veins.His advice was for me to put my feet up for 30 minutes twice a day .My last kidney function results were ok.

Cheers,

keepfit123

[CLLSA CLLSA]

Allopurinol counters the build up of uric acid, which can cause gout and, only very rarely in CLL, tumour lysis syndrome.

The risk of both problems is rare in CLL compared to other haematological diseases, which is why allopurinol is usually only given for the first cycle.

Continuing allopurinol for longer is usually because we have forgotten to stop it! In any case, kidney function is monitored every visit and appropriate measures taken, of course, if the results are abnormal.