6 replies to this topic

[mck_001]

Last week, my anc was 1.0 and this week my ANC is 0.9 and I'm waiting to hear back from the nurse to see if any extra precautions need to be taken.  I think my onc will wait to interrupt treatment until my ANC drops to 0.5.

When your ANC drops below 1.0, what types of precuations did you take to avoid getting infections or viruses?  I read that lowered ANC may bring with it less obvious signs of being sick (runny nose, etc...)  Of course, my kids have colds right now after a good month of being relatively healthy...ugh!!  At what ANC level did you not go to public places??

Reading through what I just wrote, I sound a lot more anxious about this than I actually am...just trying to get the low down.  LOL! 

[hannibellemo]

In practical clinical terms, a normal ANC is 1.5 or higher; a "safe" ANC is 500-1500; a low ANC is less than 500. A safe ANC means that the patient's activities do not need to be restricted (on the basis of the ANC).

http://www.medterms....rticlekey=20030

Pat

[Tedsey]

mck,

I understand your anxiety.  I think the worst thing is to be nervous about this.  My last onc and her nurse had me scared out of my mind.  They told me to stay home, etc.  I missed a few holidays.  At 1.0, I don't think you need to stay home.  Even at .5 or lower.  Do what you have to do and try not to think about it so much.  Trey's advice to me really helped.  He just said to try and live as normal of a life as possible (I was worried about taking the kids to the kiddie pool---survived that).  Just keep your hands clean and try not to touch your face.  Stay away from actively sick people.  This is good advice for anyone, I guess.  And I have always been a germaphobe.  So, the caveat to watch out for bacteria (like I could see it) didn't change the way I lived my life anyway.  I was just given justification for my neurosis.

I have been diagnosed almost 11 months.  I caught pneumonia just after I got out of the hospital when I was diagnosed and started Gleevec.  My ANC was normal.  It scared the blank out of me, but I recovered.  My ANC went down quickly, just like you.  Five months after diagnosis, I caught a cold with the rest of my family.  I recovered in normal time.  My ANC was very low, about .3ish.  I was also on WBC stim shots at the time that brought me up a little. 

Right now, I have been fighting a bug with less than half an army.  All my WBC and HGB decided to tank again (PLT yesterday were 22,000--oh my!).  I am recovering from a horrible stomach bug since last Wed.   I am considerably better today.  So, it appears, even with low ANC, you can get sick and recover.  Not that you should go around and throw caution to the wind or anything.  I just would hate for you to be so anxious about this.  It is not worth it.  

If you get below .5, your onc will probably want to give you a couple of drug breaks before he or she gives you stim shots.  I think you are new enough to this where your ANC may make a comeback on its own (for many people it does).  I am rootin' for ya girl.

Teds

[mck_001]

Dr. Cortes's PA just emailed me and said that if I stay below 1.0, then we will try lowering the dose of Sprycel.  I really do not want to go lower on the dose or take any breaks, even though that is not uncommon, so I'm hoping my ANC very soon follows the same path as my platelets which are back up to 95 after dropping to 50.  I am sure a lot of people feel like this in the beginning while things are adjusting and settling, but I'm very nervous that I'm going to be in the group that things just don't follow the textbook.  Time will tell, I guess!

[CallMeLucky]

I think many don't follow the text book, so don't let that unsettle you too much.  The book is still being written!

I also wouldn't be overly concerned with a lower dosage.  It could be a good thing, some people respond to lower dosage and have less toxicity as a result.  Give it a chance, you'll find what works right for you.

Best of luck

[Tedsey]

Oh, mck,

So many of us do not follow the textbook.  But I hope you eventually do.  You are new to this journey.  There is much hope things will imporove.  Hang in there.  I know how tough this can be.

[scuba]

Textbook?  There's a textbook?

Seems to me it's an ad hoc recipe with a pinch here and there that can't be duplicated.  It's French cooking.

ANC above .5 is tolerable - but dropping counts is an alarm bell to the Oncologist.  So in my case they interrupted treatment for 3 weeks.

The belief is that either or both of my cell lines (leukemic and normal) will get a jump start with the hope that the normal cells jump first.

And then back on treatment at a lower dose.  Other Oncologists 'pinch' a different way.

It does seem that suppression is somewhat normal in the beginning of treatment and that many get back to normal while treatment proceeds.

I am - it seems - on the back side of this and appear to be coming out of it.  You will probably do the same.  It is good to know that many still can get to PCRu in record time even with lowered dosage and TKI breaks.  It's all a dance as you spiral the leukemic cells down to oblivion.

But I can tell you - going off all meds for 3 weeks was a treat.  So if you get the go-ahead to go off medication for a short time - plan a vacation and enjoy it.  It's so nice to travel somewhere and not have to remember to take your drug - just your passport.