Anyone on Ibrance have lowering haemoglobin and rising liver enzyme AST? Concerned it may be cancer in marrow....

[Olha]

Hi all

I've been on Ibrance and Letrozole since MBC diagnosis in August 2019 to bones and marrow (after primary bilateral mastectomy, immediate lat dorsi reconstruction, chemo, rads, and Herceptin in 2010). Stable CT scans since, but now AST liver enzyme rising, my Ferritin (which is odd with low haemoglobin) and AST is very high, my haemoglobin has started to drop since Christmas after being stable at just normal range of 115g/L, WBC always low from Ibrance so I am on 75mg and a 2 week break. LDH has gone through the roof to 2483 (normal top of the range is 214!). All my other liver function tests are normal apart from AST but I am having a full liver report done. Told it is probably Ibrance or baddies growing in the marrow.... so feeling so very anxious and worried what treatment is possible next. I have read that if you have bone metastases then it is often in the marrow too, but doesn't always affect the blood.

Thank you so much for any input!

Best wishes to you all,

Kate

[Dolphin_]

Hi Kate. I have been on the same drugs as you for a year and bloods are always crashing and have to wait for bone marrow to recover ..I started on high dose now on 75mg and it still crashes apart from that my oncologist say the rest of my bloods are normal never mentions liver . I have metastases in my T3 ..like you I'm worried something going on I'm having a bone scan done and hope all is ok .Because my cancer in my plexus was missed for 2 years .fobbed me of with things like trapped nerve , so tumour has now strangled the plexus which is main nerve to arm .I have now lost the use of arm and my hand is clawed ,I don't trust anyone anymore ..Do if I'm not happy I will push for every test I can get ,.I hope you get good results and no baddies

Best wishes Cherylx

[Olha in reply to Dolphin_]

Hi Cheryl Thank you for your reply. I do hope your scan is good and I’m so sorry to hear about your arm.

I’m going to see a haematologist who will hopefully help more than my onocologist.

My best wishes, Kate

[atoth17]

Hi Olga, You didn’t mention an Aromatase Inhibitor, are you on Letrozole by chance? That one made my liver enzymes elevate consistently, my Onc disagreed but once I stopped they went back to normal. I’m on Ibrance 125mg and changing to 100mg next cycle due to low WBC. I have a small liver met with the rest in my bones. Exemestane has been working really well for me. I hope that helps and that your doctor can offer you some help and hope.

[Olha in reply to atoth17]

Hello!Thank you so much for your reply - that is really interesting - yes I am on Letrozole too. Have stopped IBrance to see if the enzymes come down but still on Letrozole....I’ll have to see what the onc says to that! Was it all liver enzymes - for me it’s only the AST?

[atoth17 in reply to Olha]

Yes, for me it was all liver enzymes. My Doctor disagreed that it could be the Letrozole but my numbers had been elevated for at least a year (I was on it for seven years). I had not been taking Ibrance yet, I stopped Letrozole when we started to suspect I was stage IV (diagnosed Nov 2020). On paper, Letrozole doesn’t appear to affect enzymes but it ended up being the culprit for me. It may not be true for you but it’s worth exploring the idea with your doctor.

[Olha in reply to atoth17]

Thank you. It’s interesting about the Letrozole. I have an appointment soon with a haematologist when I willfind out more! Best wishes, Kate

[Olha]

Thank you Sandra. It’s helpfulto know your LDH is still above normal. Apparently my high AST might be something to do with the red blood cells which can also be indicated by high AST levels, especially as no other liver tests are elevated. Am waiting for an appointment with a haematologist and a little nervous as this could mean marrow is being further compromised...unfortunately my oncologist is not very interested in any other ‘terrain’ markers so I am grateful I will now be speaking to other specialists.Best wishes, Kate