Discussion Forums > Thalassemia Major

Low White Blood Cell count

(1/3) > >>

Danniel:
Hello friends!

I want to share with you my strange condition in past 2 years.
Before Nov 2008 my stats was good. 2 packs of blood every 4 weeks. My Hb level pre-trans 8-8.5, and after transf 10.5-11 ....sometimes even 12.
Well in November i changed to my chelator from Desferal to Exjade.  My ferritine level before exjade was around 2200.
In the first weeks everything seemed to be fine. I was monitored weekly. After a few months i started to feel tired......I EVEN WAS SLEEPING IN THE AFTERNOON ( i almost never sleep in the afternoon).
Then my Hb level started to drop. Before transf. my Hb level 6-6.5. I started to take 2 packs every 3 weeks. Still my post-transf Hb level doesn't pass 8.5-9 ...... AFTER 3 PACKS OF BLOOD WITH 220ml each! :-\
Then i changed to 3 packs every 2 weeks. The same result! Before transf Hb=6 and after 9 at most!
Doctors didn't say anything! Even they were frustrated that i asked for extra blood! :| They said to remove my spleen! I didn't want to! My spleen is a little enlarged but no way of removal!


4 NOVEMBER 2010 My blood results was bad! My white blood cells count are low 3.5 .......... Sick of so many transf. i googled Exjade side effects. And i found that my problem is Exjade!
4 NOVEMBER 2010 I stopped Exjade!
18 NOVEMBER 2010  My next transfusion. Pre-trans Hb level 7.2. After transfusion Hb=9.6. White cell 5.2!!!!!! Wow i said!!!!  :biggrin
18 NOVEMBER 2010 Started Desferal!
20 DECEMBER 2010 After 3 packs of blood my Hb = 11.6  :cheer
..................

And now something recent:

Yesterday i had my transfusion. I take 2 packs of blood ( ~ 220 ml each ). One pack in one day, and the other pack next day.
Pre-trans Hb = 6.4
After my last transf. my Hb level was 9.7 My Ferritine lvl: 1300
But something else concerns me......the doctor said that my white blood cell count is 3.4 again ( the range is between 4.0 and 10 )
And they said to me that i should think about removing my spleen!!!!!!!

What do you think ? What is this weird thing that is happening to me ?
Everything was so normal before 2008. I don't have any problems with my heart or any organ! Damn i even have a Medical Certificate Class 2 for private pilots!

I hope i didn't bore you with my story!

nice friend:
em always been  worried abt my high white Cells count :S ,, but thanx GOd now its much more near Normal Range ....

Sharmin:
Danniel,

Before removing your spleen your doctors should consider doing Coombs test and other tests to see if you have developed immunity to certain antigens in foreign blood - possibly even auto antibodies.  After these tests are done, you may require better screening for blood or you may need to be on an acute treatment with prednisone. 

Your spleen may be part of the problem, but I think that is because your pre transfusion hg has been low from the start.  You should never let you your hg go below 90.  Ideally you should transfuse when your hg is 95 to 100.  The ideal treatment for you is hypertransfusion until your spleen returns to normal.  You should be transfused quicker, even if less volume is given each time.  Giving blood once your hg drops too low only causes the hg to be depleted quicker.  Please keep us posted Danniel, we are happy to work through this with you.  I do think your spleen is causing this, but I think that the first step is to try to shrink rather than remove your spleen. 

Sharmin

Andy Battaglia:
I am of the opinion that the spleen should not be removed unless one of two things happens. First, if the blood turnover is so fast that patients need transfusions much too soon over an extended period of time. Second, if the spleen grows so large that it is a physical danger to the patient. If neither of these scenarios exist, I say keep your spleen. The advice to remove it is often based on outdated ideas that no longer justify splenectomy and ignore the eventual side effects that splenectomy can lead to, such as thrombosis.

Danniel:
I totally agree with you Andy......As you can see, since Nov 2008 i need more packs of blood to raise my Hb.
As Sharmin said, i should transfuse when my Hb is 9.5.
Now my Hb is 9.5.....My last transfusion was Thursday,  that means i should transfuse this week again, let's say 2 pack of blood .....am i right ?
My doctors wouldn't be pleased to hear that......
And another question: How fast Hb drops ?

Navigation

[0] Message Index

[#] Next page