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How long after SCT do your red counts start improving
Hi Everyone, I am new to this site and just found it the other day. My husband was diagnosed with multiple myeloma last July. One month ago he had his stem cell transplant and is doing well. Still gets very tired and out of breath much easier than before this all happened, which I know is to be expected. We went in for his weekly labs today and his white count was good and ANC was good and his platelets are continuing to go up. Last week his hemoglobin was 9.8 and this week it dropped to 9.2. All of his red counts were worse this week. I know it has only been just 4 weeks since the transplant but can any tell me how long these will continue to go up and down? This week he will be starting his maintenance program which will consist of the Revilmed/Dex. How long does it take for his counts to go up and stay consistent? How long do they continue to be on a rollercoaster? I wonder and worry everyday about whether the procedure worked. I do understand that being on Revilmed can cause his counts to drop also. Maybe it is too soon as it has only been just 4 weeks. Please can anyone put my mind at ease. I would greatly appreciate it.
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vbjose - Name: vbjose
- Who do you know with myeloma?: husband
- When were you/they diagnosed?: July, 2012
- Age at diagnosis: 57
Re: How long after SCT do your red counts start improving
Revlimid can affect platelet and neutrophil counts - but I have not heard that it adversly affects RBC or Hb counts. With respect to RBC counts, I have heard that dexamethasone (rather than Revlimid) is the most important component in increasing RBC and Hb counts - so it may well take some time in your husband's case with Revlimid alone.
Also, while I did not have an ASCT, I did observe the following pattern - which may give you comfort - as my Hb count gradually increased from 8.0 to 13, a process that took more than 6 months. Hb levels would first reach an all time high after one month, then drop a bit the next month, then reach a new all time high the next month.....and so on.... until finally reaching the current levels between 13.1 and 13.7. A bit weird but consistent....and yes, a bit like a rollercoaster.
Also, while I did not have an ASCT, I did observe the following pattern - which may give you comfort - as my Hb count gradually increased from 8.0 to 13, a process that took more than 6 months. Hb levels would first reach an all time high after one month, then drop a bit the next month, then reach a new all time high the next month.....and so on.... until finally reaching the current levels between 13.1 and 13.7. A bit weird but consistent....and yes, a bit like a rollercoaster.
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Dan D
Re: How long after SCT do your red counts start improving
Hi Vbjose...I have posted the following information about blood cells, taken from Wikipedia. Remember that the auto stem cell transplant involves the destruction of your marrow with melphalan, before your previously harvested stem cells are returned to you. wHEn the transplant occurs, you are left with just the blood cells already circulating in the blood. The new stem cells must produce new blood cells, and this can take a while! The circulating red blood cells can live for about 120 days in the bloodstream, whereas the white blood cells, such as leukocytes, live for only 3-4 days.
So following the transplant, some red blood cells will disappear from your blood, and it may take a while for the marrow to produce new ones. That could be one reason why your red blood cell counts are down a month after the transplant. It should all readjust to normal as the stem cells in the marrow produce new cells.
After I had my auto stem cell transplant, I had 100 days with no treatments, in order to recover. After that, I started Revlimid.
Hope this helps you to figure out what might be happening with your blood counts!
Blood cell
From Wikipedia, the free encyclopedia
Blood components
A blood cell, also called a haematocyte, is a cell produced by haematopoiesis and normally found in blood. In mammals, these fall into three general categories:
Red blood cells – Erythrocytes
White blood cells – Leukocytes
Platelets – Thrombocytes.
Together, these three kinds of blood cells add up to a total 45% of the blood tissue by volume, with the remaining 55% of the volume composed of plasma, the liquid component of blood.[1] This volume percentage (e.g., 45%) of cells to total volume is called hematocrit, determined by centrifuge or flow cytometry. Hemoglobin (the main component of red blood cells) is an iron-containing protein that facilitates transportation of oxygen and other respiratory gases to tissues.
Red blood cells (Erythrocytes)
Red blood cells primarily carry oxygen and collect carbon dioxide through the use of hemoglobin, and have a lifetime of about 120 days. In the process of being formed they go through being a monopotent stem cell. They have the job alongside the white blood cells of protecting the healthy cells.
White blood cells (Leukocytes)
White blood cells are cells of the immune system involved in defending the body against both infectious disease and foreign materials. Five different and diverse types of leukocytes exist, but they are all produced and derived from a multipotent cell in the bone marrow known as a hematopoietic stem cell. They live for about 3 to 4 days in the average human body. Leukocytes are found throughout the body, including the blood and lymphatic system.
Platelets (Thrombocytes)
Platelets, or thrombocytes, very small, irregularly shaped clear cell fragments (i.e. cells that do not have a nucleus containing DNA), 2–3 µm in diameter, which derive from fragmentation of precursor megakaryocytes. The average lifespan of a platelet is normally just 5 to 9 days. Platelets are a natural source of growth factors. They circulate in the blood of mammals and are involved in hemostasis, leading to the formation of blood clots. Platelets release thread-like fibers to form these clots.
If the number of platelets is too low, excessive bleeding can occur. However, if the number of platelets is too high, blood clots can form (thrombosis), which may obstruct blood vessels and result in such events as a stroke, myocardial infarction, pulmonary embolism—or blockage of blood vessels to other parts of the body, such as the extremities of the arms or legs. An abnormality or disease of the platelets is called a thrombocytopathy, which can be either a low number of platelets (thrombocytopenia), a decrease in function of platelets (thrombasthenia), or an increase in the number of platelets (thrombocytosis). There are disorders that reduce the number of platelets, such as heparin-induced thrombocytopenia (HIT) or thrombotic thrombocytopenic purpura (TTP) that typically cause thromboses, or clots, instead of bleeding.
Platelets release a multitude of growth factors including Platelet-derived growth factor (PDGF), a potent chemotactic agent, and TGF beta, which stimulates the deposition of extracellular matrix. Both of these growth factors have been shown to play a significant role in the repair and regeneration of connective tissues. Other healing-associated growth factors produced by platelets include basic fibroblast growth factor, insulin-like growth factor 1, platelet-derived epidermal growth factor, and vascular endothelial growth factor. Local application of these factors in increased concentrations through Platelet-rich plasma (PRP) has been used as an adjunct to wound healing for several decades.
So following the transplant, some red blood cells will disappear from your blood, and it may take a while for the marrow to produce new ones. That could be one reason why your red blood cell counts are down a month after the transplant. It should all readjust to normal as the stem cells in the marrow produce new cells.
After I had my auto stem cell transplant, I had 100 days with no treatments, in order to recover. After that, I started Revlimid.
Hope this helps you to figure out what might be happening with your blood counts!
Blood cell
From Wikipedia, the free encyclopedia
Blood components
A blood cell, also called a haematocyte, is a cell produced by haematopoiesis and normally found in blood. In mammals, these fall into three general categories:
Red blood cells – Erythrocytes
White blood cells – Leukocytes
Platelets – Thrombocytes.
Together, these three kinds of blood cells add up to a total 45% of the blood tissue by volume, with the remaining 55% of the volume composed of plasma, the liquid component of blood.[1] This volume percentage (e.g., 45%) of cells to total volume is called hematocrit, determined by centrifuge or flow cytometry. Hemoglobin (the main component of red blood cells) is an iron-containing protein that facilitates transportation of oxygen and other respiratory gases to tissues.
Red blood cells (Erythrocytes)
Red blood cells primarily carry oxygen and collect carbon dioxide through the use of hemoglobin, and have a lifetime of about 120 days. In the process of being formed they go through being a monopotent stem cell. They have the job alongside the white blood cells of protecting the healthy cells.
White blood cells (Leukocytes)
White blood cells are cells of the immune system involved in defending the body against both infectious disease and foreign materials. Five different and diverse types of leukocytes exist, but they are all produced and derived from a multipotent cell in the bone marrow known as a hematopoietic stem cell. They live for about 3 to 4 days in the average human body. Leukocytes are found throughout the body, including the blood and lymphatic system.
Platelets (Thrombocytes)
Platelets, or thrombocytes, very small, irregularly shaped clear cell fragments (i.e. cells that do not have a nucleus containing DNA), 2–3 µm in diameter, which derive from fragmentation of precursor megakaryocytes. The average lifespan of a platelet is normally just 5 to 9 days. Platelets are a natural source of growth factors. They circulate in the blood of mammals and are involved in hemostasis, leading to the formation of blood clots. Platelets release thread-like fibers to form these clots.
If the number of platelets is too low, excessive bleeding can occur. However, if the number of platelets is too high, blood clots can form (thrombosis), which may obstruct blood vessels and result in such events as a stroke, myocardial infarction, pulmonary embolism—or blockage of blood vessels to other parts of the body, such as the extremities of the arms or legs. An abnormality or disease of the platelets is called a thrombocytopathy, which can be either a low number of platelets (thrombocytopenia), a decrease in function of platelets (thrombasthenia), or an increase in the number of platelets (thrombocytosis). There are disorders that reduce the number of platelets, such as heparin-induced thrombocytopenia (HIT) or thrombotic thrombocytopenic purpura (TTP) that typically cause thromboses, or clots, instead of bleeding.
Platelets release a multitude of growth factors including Platelet-derived growth factor (PDGF), a potent chemotactic agent, and TGF beta, which stimulates the deposition of extracellular matrix. Both of these growth factors have been shown to play a significant role in the repair and regeneration of connective tissues. Other healing-associated growth factors produced by platelets include basic fibroblast growth factor, insulin-like growth factor 1, platelet-derived epidermal growth factor, and vascular endothelial growth factor. Local application of these factors in increased concentrations through Platelet-rich plasma (PRP) has been used as an adjunct to wound healing for several decades.
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Nancy Shamanna - Name: Nancy Shamanna
- Who do you know with myeloma?: Self and others too
- When were you/they diagnosed?: July 2009
Re: How long after SCT do your red counts start improving
Thank you Dan and Nancy for the responses. It does put my mind at ease some. I just thought his counts should be going up instead of down 40 days from his transplant. Like I said his transplant was on June 6 and on June 24th his hemoglobin was slowly going up and it was up to 9.8 and now as of yesterday it had dropped to 9.2. I guess we just thought by now he should have started making new cells and things would be moving up instead of down. His white counts and neutrophil counts are all good and his platelets went up about 20. He will start his revilimed and dex sometime this week and I know this might cause his counts to drop again. I am just hoping and praying things start improving where his counts are concerned by then. Thanks so much for responding, it is so nice to finally find a site where I can communicate with others going through this and get some answers to all oft he questions we have.
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vbjose - Name: vbjose
- Who do you know with myeloma?: husband
- When were you/they diagnosed?: July, 2012
- Age at diagnosis: 57
Re: How long after SCT do your red counts start improving
I had my SCT end of January and it took me about 60 days post transplant for my reds to level out and my whites are still border line. But, my doc warned me that your blood counts can vary day to day so not to worry if they a higher one day and lower the next. Key is that over the weeks the trend is working its way back to normal. Mine did take a little bit of a hit when I started maintenance. I take 10mg of Revlimid daily. Jerry.
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JBarnes - Name: Jerry Barnes
- Who do you know with myeloma?: Self
- When were you/they diagnosed?: Aug 17, 2012
- Age at diagnosis: 54
Re: How long after SCT do your red counts start improving
Jerry,
Thank you for taking the time to respond to me. It means a lot that people that are also going through the same thing can take time to let others know their thoughts and treatments. I wish you the best of luck in your treatment and please keep me updated on your progress.
Thank you for taking the time to respond to me. It means a lot that people that are also going through the same thing can take time to let others know their thoughts and treatments. I wish you the best of luck in your treatment and please keep me updated on your progress.
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vbjose - Name: vbjose
- Who do you know with myeloma?: husband
- When were you/they diagnosed?: July, 2012
- Age at diagnosis: 57
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