Low platelets before chemo

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Jen43
Posts: 13
Joined: Sat Mar 23, 2019 9:52 pm

Low platelets before chemo

Postby Jen43 » Thu Jun 20, 2019 4:01 pm

Has anyone done FOLFOX with platelets already low mine are 80-100

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Green Tea
Posts: 202
Joined: Mon Oct 24, 2016 10:48 am
Location: Nusa Tenggara

Re: Low platelets before chemo

Postby Green Tea » Thu Jun 20, 2019 5:34 pm

Jen43 wrote:Has anyone done FOLFOX with platelets already low mine are 80-100

Low platelet count
https://www.chemotherapy.com/side_effects/thrombocytopenia/

debsta
Posts: 9
Joined: Sat Mar 30, 2019 11:00 am
Location: Boston MA

Re: Low platelets before chemo

Postby debsta » Thu Jun 20, 2019 6:14 pm

I've been concerned about my husband's platelet count which gets lower every visit, is it currently at 128 which is out of the normal range.

His team has explained that they aren't concerned until it hits 90, at which point they will give him an IV transfusion prior to his chemo session.
Caregiver of DH age 68 at DX w/Stage IVb rectal adenocarcinoma - mets in liver and both lungs
MSS MMRp Kras/Braf/Ras all wild-type TMB 3.04 poorly differentiated CEA 14.7
2/2019 Clinical Trial at Dana Farber - mFolfox6, Avastin, Nivolumab
9/13/2019 CEA 1.0 67% reduction by Recist dropped Oxaliplatin due to neuropathy

lovelife789
Posts: 141
Joined: Thu Aug 24, 2017 5:28 am

Re: Low platelets before chemo

Postby lovelife789 » Thu Jun 20, 2019 9:50 pm

Hi Debsta,

I have done FolFox before and before one cycle (can't remember it was #5/6), my platelets suddenly dropped to 55... I was almost immediately hospitalized.

Anyway, I was allowed to go home at last. I was then drinking a tea made out of peanut skin and red dates (you can buy both from Amazon), day and night for 3 days. I went back for another blood test 3 days later, it was back to 117. Doubled it in 3 days was a record.

From that point onwards, I would start drinking it 5 days prior to my blood work, and it never fell below 110 until I finished cycle 13.

May not be a popular solution in other countries. But I have done it myself and it works. It doesn't directly help WBC though... Which is a problem I'm having now.... :oops: :oops: :oops:
F/38 - Dx 8 Mar 17, CEA 189.5
Stage IV Sig. Colon, Liver mets, T3N0M1a, KRAS NRAS Wild, G2=Mod. differentiated
3/17- 6/17 - 6 rounds of FOLFOX + Erbitux - CEA 2.5
7/17 - 1st Liver resect/Colon/Gall, all clear margin
8/17 - 2nd Liver resec
9-12/17' - completed 13 rounds of FOLFOX - CEA 1.0
1/18 - 6/30 - NED
6/30 - PET SCAN showed a lung nodule that grew from 5mm to 8mm - CEA 1.0
8/30 - VATs
8/30 - 4/30 - NED
5/28 - uptake seen in 1 x PALN, 1x common iliac, cloudy in Liver
FOLFIRI + Avastin

boxhill
Posts: 336
Joined: Fri Apr 06, 2018 11:40 am

Re: Low platelets before chemo

Postby boxhill » Thu Jun 20, 2019 10:07 pm

My platelets were barely scraping the low end of the normal range when I started Folfox, maybe around 140, and went steadily down from there. I had to postpone chemo a week for the count to come back up a few times. My count was below 80 many times, and no one ever mentioned getting a transfusion. Is there some other condition that complicates matters? Similarly, I can't imagine being hospitalized at a count of 50 unless a bleeding problem had actually developed or there was some other issue/condition that made the situation unusually dangerous.

A platelet count of 128 is very safe, according to my understanding, anyway. I finished chemo around Nov 9, 2018, and my platelets didn't hit the "normal" range until last month.

My WBC count also dipped way down and caused a delay, but that they were able to fix by giving me neulasta.
F, 64 at DX CRC Stage IV
3/17/18 blockage, r hemi
11 of 25 nodes,5 mesentery nodes
5mm liver met out
pT3 pN2b pM1
BRAF wild, KRAS G12D
dMMR, MSI-H
5/4/18 FOLFOX
Neulasta 6/28
7/9/18 CT NED
11/20/18 CT NED. Enlarged spleen.
12/20/18 Liver MRI 5mm liver met? and 2 lymph nodes in porta hepatis
12/31/18 Keytruda
6/5/19 Triphasic CT LN and spleen normal, Liver node stable
6/28/19 Pause Keytruda, predisone for joint pain
7/31/19 Restart Keytruda
9/10/19 CT stable

lovelife789
Posts: 141
Joined: Thu Aug 24, 2017 5:28 am

Re: Low platelets before chemo

Postby lovelife789 » Thu Jun 20, 2019 10:16 pm

boxhill wrote:My platelets were barely scraping the low end of the normal range when I started Folfox, maybe around 140, and went steadily down from there. I had to postpone chemo a week for the count to come back up a few times. My count was below 80 many times, and no one ever mentioned getting a transfusion. Is there some other condition that complicates matters? Similarly, I can't imagine being hospitalized at a count of 50 unless a bleeding problem had actually developed or there was some other issue/condition that made the situation unusually dangerous.

A platelet count of 128 is very safe, according to my understanding, anyway. I finished chemo around Nov 9, 2018, and my platelets didn't hit the "normal" range until last month.

My WBC count also dipped way down and caused a delay, but that they were able to fix by giving me neulasta.


Oh what my doctor said back then about my platelets at 50 was that internal bleeding can happen anytime at anything below 50. They needed to monitor my situation (so there goes hospitalization because there isn't a lot of day clinics where I live).

Was Neulasta shot tough? I really don't want muscle pain and joint pain as FolFiri gave me intense nausea beyond medication control, if I add joint pain and muscle pain, I would be pretty paralyzed... :? :? :?
F/38 - Dx 8 Mar 17, CEA 189.5
Stage IV Sig. Colon, Liver mets, T3N0M1a, KRAS NRAS Wild, G2=Mod. differentiated
3/17- 6/17 - 6 rounds of FOLFOX + Erbitux - CEA 2.5
7/17 - 1st Liver resect/Colon/Gall, all clear margin
8/17 - 2nd Liver resec
9-12/17' - completed 13 rounds of FOLFOX - CEA 1.0
1/18 - 6/30 - NED
6/30 - PET SCAN showed a lung nodule that grew from 5mm to 8mm - CEA 1.0
8/30 - VATs
8/30 - 4/30 - NED
5/28 - uptake seen in 1 x PALN, 1x common iliac, cloudy in Liver
FOLFIRI + Avastin

debsta
Posts: 9
Joined: Sat Mar 30, 2019 11:00 am
Location: Boston MA

Re: Low platelets before chemo

Postby debsta » Fri Jun 21, 2019 6:51 am

@boxhill - No, no other conditions which might make a platelet count of 128 or 90 risky. Thankfully all we are dealing with is his rectal cancer, no other complications. He is in a clinical trial though, and it might very well be the trial has guidelines for platelet count. I know we have to keep his potassium and magnesium above specific levels and his weight within 5% of his starting weight, etc.

@lovelife - My husband also had a low neutrophil count and so now gets a shot of Neulasta at disconnect. He has not experienced any adverse side effects from this shot but does take a 24-hour Claritin D non-drowsy tablet for five days (starting on disconnect day) to help offset any bone pain he might develop.
Caregiver of DH age 68 at DX w/Stage IVb rectal adenocarcinoma - mets in liver and both lungs
MSS MMRp Kras/Braf/Ras all wild-type TMB 3.04 poorly differentiated CEA 14.7
2/2019 Clinical Trial at Dana Farber - mFolfox6, Avastin, Nivolumab
9/13/2019 CEA 1.0 67% reduction by Recist dropped Oxaliplatin due to neuropathy

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Jack&KatiesMommy
Posts: 595
Joined: Wed Dec 21, 2011 1:08 pm
Location: Columbus, OH

Re: Low platelets before chemo

Postby Jack&KatiesMommy » Fri Jun 21, 2019 8:09 am

My platelets haven't been above 90 for 4 years. I have done Irinotecan and Xeloda with platelet counts in the 80's. Liver treatment and damage can cause an enlarged spleen and chronic low platelet counts I have been told. no one seems to worry about mine.
Cynthia
Cynthia
Mommy to Jack (8) now (16) and Katie (4) now (12)
(My Most Precious Things)
Dx 8/11 Stage IV CRC (liver mets) CEA 2,600+
9/11 Folfiri 2/12: Failed Liver Resection
5/12 HAI pump/removed primary
4/13 Liver Resection
8/13-12/15 (10) RFAs lungs
5/17: Upper Left Lobe of lung resected.
02/18: 3 new mets lymph nodes lung:
05/18: Keytruda (MSS w/Intermediate TMB): CEA: 66.4, 39.2, 23.8, 13, 3.5 1.8, 1.0, 2.8 3.9, 5.0, 5.6, 1.5, .8, .8, 1.1, 1.1, .7
7/18; 9/18; 11/18; 2/19 Clear CT scans

fumaros
Posts: 265
Joined: Sat Jul 02, 2016 10:26 pm
Location: Syracuse, NY
Contact:

Re: Low platelets before chemo

Postby fumaros » Fri Jun 21, 2019 11:47 am

I second what lovelifr789 said, it can sometimes be dietary related. I usually have decent platelet counts and they dipped almost to dangerous lows when i began eating Tahini butter. I stopped and not two weeks later, they have climbed back to normal.
Diagnosed 4/8/16, age 29
Colectomy 4/20/16
Stage III, T4bN1 Tumor 7x6.5x2. Muscinous Adenocarcinoma with SRC features
2/16 lymph nodes
Stage IV, Peri mets 5/2019
CEA 4/14/16 - 16.8
CEA 6/2/16 - 1.9
CEA 6/17/16 - 0.87, 7/16 - 1.33, 12/16 - 1.14, 4/17 - 0.6, 7/17 - 0.5, 10/17 - 0.9, 3/19 -5.8, 4/19 -10
FOLFOX began 6/24/16 - 11/25/16, FOLFIRI - 5/10/19
10 round FOLFOX, 2 round 5-FU & Leucovorin, 1 round FOLFIRI
MRI & CT 8/16 - NED, CT 12/16 - 10/17 - NED

boxhill
Posts: 336
Joined: Fri Apr 06, 2018 11:40 am

Re: Low platelets before chemo

Postby boxhill » Fri Jun 21, 2019 1:12 pm

I found Neulasta to be effective and no problem as long as I took my daily Claritin. (They told me to just take the regular kind, not decongestant, FWIW.)

My last scan showed that me spleen was back to normal, after having been enlarged--I'm told an oxaliplatin thing, like so much else--which I'm sure has helped bring my platelets up.
F, 64 at DX CRC Stage IV
3/17/18 blockage, r hemi
11 of 25 nodes,5 mesentery nodes
5mm liver met out
pT3 pN2b pM1
BRAF wild, KRAS G12D
dMMR, MSI-H
5/4/18 FOLFOX
Neulasta 6/28
7/9/18 CT NED
11/20/18 CT NED. Enlarged spleen.
12/20/18 Liver MRI 5mm liver met? and 2 lymph nodes in porta hepatis
12/31/18 Keytruda
6/5/19 Triphasic CT LN and spleen normal, Liver node stable
6/28/19 Pause Keytruda, predisone for joint pain
7/31/19 Restart Keytruda
9/10/19 CT stable


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