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Old Sun Sep 24, 2017, 12:10 PM
Hopeful Hopeful is offline
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Join Date: Jan 2009
Location: California, USA
Posts: 766
Quote:
Originally Posted by JoMac53 View Post
It's my understanding Granix (tbo-filgrastim) and Procrit are not FDA approved for MDS because they can increase the blast count but my doctor wants to give me both.

My last blood counts were WBC 2.7 (ANC 0.3), RBC 3.96 (Hgb 9.5), platelets 118.

According to the BMB flow cytometry I have "Left-shifted myeloid maturation pattern with 1.8% myeloid blasts." It says "the findings raise concern for a myeloid neoplasm" but to correlate with the manual blast count because the flow cytometry can over or under estimate the blast count. The manual count said "up to 5-6% in CD43 stained trephine biopsy sections."

I have taken the Granix once but refused the Procrit. Have these drugs become accepted as an off-label use for MDS? Does anyone know the actual risk of increased blasts? Do they decrease if the drugs are stopped? I've been searching for answers online but not getting anywhere. Any info would be most appreciated.
Hi JoMac53,

Are you RBC transfusion dependent? Have you had your EPO tested and was it low? Most studies that I have seen indicated that Procrit/Arsnep are not likely to work if someone has a normal or high EPO.

That being said, when I was transfusion dependent, my EPO was tested and was low. My hematologist refused to give me the Procrit shot because he had previously worked with patients that had solid tumors, and they had died because EPO shots had increased their cancer growth. When he told me that, I stopped asking for the shot!

I tend to think that if you don't need the shots (aren't transfusion dependent) don't get them. The shots don't work forever (if they do work) so it is better to save them in your bag-of-tricks for when they are needed most.
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55 yo female, dx 9/08, AA/hypo-MDS, subclinical PNH, ATG/CsA 12/08, partial response. small trisomy 6 clone, low-dose cyclosporine dependent
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