increased effects of hydroxycarbamide and Anagrelide due to CKD

[jointpain]

My wife has MF and now CKD of the one kidney she has left, the drugs for her MF are affecting the FBC more so than previously.i asked her hematologist if it was the reduced function of her kidney causing dramatic reduction in platelets and Hgb , while her white cells are four times normal count. Apparently I am overthinking this.

ncbi.nlm.nih.gov/pmc/articl... is a paper that agrees with me, I think. Has anyone else having the same issues with their bloods?

[hunter5582]

One would expect to see a reduction in platelets on the combination of hydroxycarbamide and anagrelide. That is the intended effect. Anagrelide more specifically targets platelets. Hydroxycarbamide affects all blood cell types. If your wife has only one kidney, then there would be a cause for concern if there is new evidence of increased CKD. Note that hydroxycarbamide can impair kidney function and cause renal failure.

You are not overthinking this. It is a legitimate concern. Suggest reviewing the situation with a MPN Specialist and a nephrologist. They can give you the best guidance on what is going on.

[jointpain in reply to hunter5582]

Thank you for your reply. The hematologist has reduced the Anagrelide from 3 per day to 1 a day yet left the hydroxycarbamide at 3 a week. A couple of months ago the Anagrelide was increased to 4 tablets a day but that was short lived as she had a massive GI bleed requiring 6 bags of packed RBCells, which brought her Hgb to 117 it's now 91 and dropping platelets are 98 white cells are 39! She feels OK and we went for a 21 mile bike ride yesterday albeit she was on a E bike. Our trouble is a lack of information of blood test results from the hospital.

[hunter5582 in reply to jointpain]

That is a very low dose of hydroxycarbamide. With the anagrelide dropped back. platelets should not be as affected. Has the hematologist discussed other options to treat the MF such as a JAK-inhibitor?

I do not recall whether your wife is seeing a MPN Specialist or a regular hematologist. AT this stage, MPN-expert consultation would be very important.

I do not quite understand the lack of information on blood test results. It should be quite simple to access these. I can look up all my results myself in patient portals. Others have noted that some parts of the healthcare system do not have this, but everyone has the right to get a copy of their records any time they wish.

Hope you get it all sorted soon.