Where Oh Where Have My Neutrophils Gone?

In advance of tomorrow's planned fourth Darzalex infusion, the doctors did a CBC with differential today to see how my neutrophils were standing up to the Darzalex / Pomalyst combination.  Surprise!  Neutrophils were just 400/uL, where the reference range for this lab is 1800 to 7700 /uL. In other words, my neutrophils measured less than one fourth of the value representing the very bottom of the reference range - the lowest count that I remember in almost 13 years with myeloma.  Doctors and nurses were all asking if I felt OK, because a low neutrophil count (neutropenia) can result in neutropenic fever, potentially a life-threatening condition.  In the past my doctors have stopped treatment when neutrophils dropped below 1000. So what do we do about that?  I have a Darzalex infusion scheduled for tomorrow. First, I don't believe the number.  I don't doubt the accuracy of the test (much), but I have a history of low neutrophil counts that probably weren't low.  The neutrophils are actually there, but they don't show up (at least not as neutrophils) in a CBC with diff.  In the past, I have used two "tricks" to make the neutrophils appear:  Take the blood in the afternoon.  I have repeatedly found that my neutrophil count is at least double in the afternoon.  In lieu of afternoon, take the blood as late in the morning as possible.  Today's draw was at 7:30 am. Do some physical exercise just before the b...
Source: Myeloma Hope - Category: Cancer & Oncology Tags: neutropenia neutrophils Source Type: blogs

Related Links:

Publication date: Available online 17 January 2020Source: Best Practice &Research Clinical HaematologyAuthor(s): Dickran Kazandjian, Alexander Dew, Elizabeth HillAbstractState of the art treatment for myeloma involves using 3-drug combinations incorporating immunomodulatory drugs (IMiDs) and proteasome inhibitors (PIs). Clinical trials for 4-drug combinations incorporating monoclonal antibodies added to IMiD and PI based backbones are underway. Recent retrospective analyses show that patients who attain MRD negativity have similar long term outcomes regardless of early or delayed high dose melphalan with autologous ste...
Source: Best Practice and Research Clinical Haematology - Category: Hematology Source Type: research
This study adds to the body of evidence in describing incidence and type of cardiac events experienced by an allogeneic and autologous HSCT population at one institution from 2012-2017. Sixty-five patients (9.8%) experienced cardiac events, including atrial arrhythmia (N = 39), acute heart failure (N = 9), acute coronary syndrome (N = 7), new onset hypertension (N = 9), with a few instances of bradycardia, ventricular arrhythmia, pericardial effusion, and pericarditis. Our multivariable regression analysis identified age (older), creatinine (higher) and history of coronary artery disease to significantly correlate with ris...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
No abstract available
Source: Oncology Times - Category: Cancer & Oncology Tags: News Source Type: research
Publication date: Available online 17 January 2020Source: Best Practice &Research Clinical HaematologyAuthor(s): Gary A. Ulaner, C. Ola LandgrenAbstractFluorine-18 (18F)-fluorodeoxyglucose (FDG) positron emission tomography (PET) allows evaluation of elevated glucose metabolism in malignancies. There has been increasing interest in FDG PET/CT for plasma cell disorders since the International Myeloma Working Group outlined multiple applications of this imaging modality, including distinguishing smoldering myeloma from active multiple myeloma, confirmation of solitary plasmacytoma, and multiple indications in patients wi...
Source: Best Practice and Research Clinical Haematology - Category: Hematology Source Type: research
Publication date: Available online 17 January 2020Source: Best Practice &Research Clinical HaematologyAuthor(s): Even H. Rustad, Eileen M. BoyleAbstractAchieving minimal residual disease (MRD) negativity in the bone marrow is one of the strongest prognostic factors in multiple myeloma. Consequently, MRD testing is routinely performed in clinical trials and moving towards standard of care. This review focuses on the role of next generation sequencing (NGS) of tumor-specific immunoglobulin V(D)J sequences for MRD tracking. The immunoglobulin variable regions are ideal targets for tracking, because every tumor cell shares...
Source: Best Practice and Research Clinical Haematology - Category: Hematology Source Type: research
Publication date: Available online 16 January 2020Source: Clinical Lymphoma Myeloma and LeukemiaAuthor(s): Bei Xiong, Mei Xue, Yalan Yu, Sanyun Wu, Xuelan ZuoAbstractTo investigate the clinical implications of SF3B1 mutation and ring sideroblasts in myelodysplastic syndrome-refractory cytopenia with multilineage dysplasia (MDS-RCMD), 238 consecutive MDS-RCMD patients were included in this study. Our results showed that SF3B1 mutation in MDS- RCMD patients identifies a distinct subgroup characterized by a high prevalence of erythroid dysplasia and a high proportion of ring sideroblasts, prolonged survival and reduced leukem...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
ConclusionThe present analysis identifies disparities in the initial management of older adults with FL owing to race and socioeconomic status. Future research should examine implications for subsequent treatment and health outcomes.
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
ConclusionLncRNA MALAT1 expedited MM tumorigenesis, invasion, and glycolysis via miR-1271-5p/SOX13 axis. MALAT1 might contribute to the therapy of MM as a promising indicator.
Source: Journal of Cancer Research and Clinical Oncology - Category: Cancer & Oncology Source Type: research
This study describes the incidence and type of cardiac events (CE) experienced by autologous and allogeneic hematopoietic stem cell transplant patients over a five-year period at one institution. 9.8% of patients experienced a CE, and those that experienced a CE had an increased risk of death within one year (p
Source: Clinical Lymphoma, Myeloma and Leukemia - Category: Hematology Authors: Tags: Original Study Source Type: research
ConclusionssBCMA level is profoundly reduced in patients with severe PAD, including those with CVID and XLA and those with IgG levels of less than 600 mg/dL. sBCMA level measurement has potential to augment clinical evaluation of PAD. Prospective studies are needed to evaluate sBCMA for new PAD diagnosis and determine the necessity of IRT.
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
More News: Dexamethasone | Myeloma | Nurses | Nursing | Sports Medicine