N plate and now Aranesp?

[iontheball]

Hi everyone,
I'm new to the forum. I have a question about my mom. She has been under the care of a hematologist for several years and had been told she had "poorly functioning bone marrow" but never needed any treatment. In November 2011 she was diagnosed with small cell lung cancer (limited stage) and started chemo. Her platelets were 110 when she started chemo. (Her RBC and WBC were in low normal range). After 2 rounds of chemo, her platelets had dropped to mid 20's. After several weeks of not improving, they did a bone marrow biopsy and diagnosed her with CMML. Her oncologist started her on N-plate. After 4-5 treatments of that, her platelets were up to 137. The oncologist stopped the Nplate last week and wants to resume chemo (at a 20% dose reduction) today if platelets are still up. Also while we were waiting for the platelets to go up her hematocrit dropped and she has had 2 blood transfusions over the past few months. Her hematocrit last week was 27. The dr spoke to them last week about possibly starting Aranesp to help. After reading about it, that scares me because of possibly causing tumors to grow larger and the other side effects as well. However, I know once she starts chemo all of her levels will drop. She's had 2 rounds of chemo--the dr said he was hoping for at least 4 rounds. Sorry this is so long winded. Any advice would be appreciated!
Thank you!

[Sally C]

Hi Iontheball - and you do sound like you're Ontheball,
I hope that some of the more learned on the forums will pitch in but here's my 2 cents worth.
It is important to keep your Mom's counts up. If you read all the drug warnings with all these meds you wouldn't have her take any of them. My husband has MDS and the Campath warnings said it could cause death - but it saved his life. He is in a clinical trial for Promacta (I have posted in detail if you're interested). The pharma warnings specifically say that no one with MDS should take it as it might make the patient's MDS transform to AML. But the drug has performed a miracle - no transfusions in 13 months after over 100 transfusions in a 2 year period. We have said that we have to pick our poisons with these drugs and hope for the best.
It sounds like your Mom needs support for her counts and the only way to get that is through drugs like Aranesp. Just as an aside, my husband took Aranesp for a year or so and tolerated it very well.
Most of dealing with MDS is using drugs to help the marrow. Most if not all of the drugs have a long list of warnings. If you trust your doctor then try to turn it over him or her - and pray if you are so inclined.
I hope this helps. Keep us posted.
God Bless,
Sally