new to interferon Hunter can you help ?

When switching to interferon injections, should you still be on 3 a day hydroxy at same time ?

[Otterfield]

Interferon takes a little time to kick in. WhenI was on it my doctor cut down my HU gradually.

However this is really a question to ask your haematologist.

[Pennypen in reply to Otterfield]

No I didnt have to

[hunter5582]

I believe Otterfield has it right. It is a common protocol to gradually reduce the hydroxy dose when switching to one of the interferons. The dose titration schedule would likely need to be individualized based on your MPN profile.

I cannot speak from personal experience as I had stopped hydroxy long before starting on Pegasys. My docs followed a protocol of monitoring CBC and CMP every two weeks until I reached a stable goal. We backed off the labs gradually. I would imagine you would be following a similar lab schedule. Given that you are taking both IFN and HU, it would be very important to monitor liver and kidney function (CMP) as well as monitor your CBC to ensure you stay in a target range.

Suggest you come up with a specific list of questions for your hematologist.

1. What is the planned dose titration schedule (up for PEG - Down for HU)?

2. What are the criteria for changing the dose(s)? What are the target ranges we are trying to maintain?

3. What are the acceptable ranges for kidney and liver function?

4. Will we be monitoring every two weeks until response is clear?

5. While on both drugs, are there any specific side effects or risks to be aware of?

Note that there are drug interactions to be aware of. This is something to discuss with your care team if you have any questions.

Monitor/Modify Tx

hydroxyurea + peginterferon alfa 2a

monitor CBC: combo may incr. risk of myelosuppression; may incr. risk of cutaneous vasculitic toxicities in myeloproliferative disorder pts (additive effects; mechanism unknown)

online.epocrates.com/intera...

Regardless of the list of potential side effects, I would be sure to report anything unusual to your care team. There can be rare adverse effects when combining drugs.

Please do get back to your care team as soon as you can for the answers you need. If you ask specific questions you are more likely to get specific answers.

Please let us know how you get on and what you learn. We can all benefit from what you learn.

[EPguy]

I did the HU transition. I was on about 1 pill per day before and we continued that for two weeks. With bloods holding well in my case I stopped the HU.

From my experience, having more frequent blood tests than usual is a good idea during the transition to be sure the counts stay in a good place. Then you can carefully decrease the HU according to the results.

As Hunter says, you need to follow CMPs (metabolic tests) closely, including ALT and AST, two liver numbers that are important to watch on IFN.