M.D. Anderson does not worry much about platelets unless it gets below 20. And a lab tech told me that they will still do bone marrow aspiration with platelets as low as 10.
On Neutrophils (ANC) - anything below 0.5 and Dr. Cortes wanted me off the meds. He did not want to restart me until I was above 1.0. When I fell to as low as 0.1 - that occurred in two weeks while I was on 70mg Sprycel in later January this year, I was told to STOP taking Sprycel. But they did not tell me to take Neupogen. Dr. Cortes wanted to watch my response and told me that if I get any fever whatsoever I was to go immediately to the emergency room. My wife almost had a heart attack on that one. The good news was that I went from 0.1 to 0.4 in one week without any fever ( off all meds) , then 0.4 to 0.6 in the second week, and then I just stayed there at 0.6 for week after week after week until week 12. During that time I never had a fever and I was traveling to New York and in the subways (I did not tell the docs) - Germs were everywhere - I could see them moving from person to person. I felt great - no meds - no side affects. Just New York in spring time. I was taking Curcumin all throughout this period (and continue to this day).
And then by week 10, my ANC started to rise from 0.6 to 0.8, then finally crossing over to 1.0 by week 12. At that point, Dr. Cortes put me on 20 mg. of Sprycel. In one week, my ANC count dropped down to 0.7, but in week two since re-start, my count stayed around 0.7. Then in week 3 following re-start, my counts started to rise to 0.8. By week 4 following re-start, my ANC went as high as 1.6 and I was thrilled. Since that time, it has hovered between 1.0 and 1.5 with my last CBC in early December at 1.3. During re-start of 20mg Sprycel - my Ph+ chromosome cytogenetics dropped to zero. Dr. Cortes told me I was on my way and he'll see me in 3 months. He said my ANC count will probably stay in that range as my new normal.
Dr. Cortes also told me via e-mail that I no longer need monthly CBC's and that I can wait until the next PCR (3 month) in February. He did say - keep an eye out for infection, fever and mouth sores (that I had when ANC went below 0.5) as guidance on getting a CBC done sooner. If I stay healthy, have no mouth sores, and no "petechia" on my skin as an indicator that platelets are getting too low then I should be fine.
There's no magic threshold - just severe or not severe. Platelets below 10 is severe. ANC below 0.5 is severe. Oncologist will vary on what is worrisome to them. M.D. Anderson has seen it all in the clinic and so have a greater tolerance to lower counts than other facilities.
Diagnosed 11 May 2011 (100% FiSH, 155% PCR)
with b2a2 BCR-ABL fusion transcript coding for the 210kDa BCR-ABL protein
Sprycel: 20 mg per day - taken at lights out with Quercetin and/or Magnesium Taurate
6-8 grams Curcumin C3 complex.
2015 PCR: < 0.01% (M.D. Anderson scale)
2016 PCR: < 0.01% (M.D. Anderson scale)
March 2017 PCR: 0.01% (M.D. Anderson scale)
June 2017 PCR: "undetected"
September 2017 PCR: "undetected"