MPN PV- Low RBC count

[neela2020]

Hi all, Hope all doing good and able to manage their blood counts in this pandemic.

I was doing well too, but now recent blood count shows drop in RBC .

I was on hydra twice daily since last year , now my doctor has reduced it to one with iron supplement.

I am really worried now what this low RBC ( little less than 3 L ) means to a PV patient. Is it because of medication and need adjustment of dose or there could be something else?

If anyone experienced this in their MPN PV journey please share your experience.

It would be really helpful to prepare mentally.

Thanks and best wishes to all.

[hunter5582]

Anemia is one of the known side effects of hydroxyurea. It can occur when your dose is too high and you overshoot the mark on your therapeutic target of HCT<45/43%. The same thing can happen as a result of too many phlebotomies. It did happen to me and I ended up with HCT=32 after being over-phlebotomized. The core purpose of the phlebotomies is to make you iron deficient but not anemic. It is a balancing act. Likewise with HU dose titration .

Assuming that is the issue, the RBCs/HCT will come back up when you restore your iron levels. I would assume your doc did an iron panel (ferritin iron/transferrin saturation, UIBC, TIBC serum iron) evaluating your current status an will repeat and watch your CBC closely to not overshoot the mark in the other direction. Iron will drive up your erythropoiesis, so you do not want to end up back in erythrocytosis.

Hope you get it all sorted out ASAP.

[neela2020 in reply to hunter5582]

Thank you so much for the response. I am feeling just fine so I believe the count will restore soon with lowering the dose and with other supplements .

CBC is due later in this week.