What Does This Blood Report Indicate?

Posted on Thu, 29 Sep 2016

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Thu, 29 Sep 2016 Answered on

Thu, 20 Oct 2016 Last reviewed on

Question : In a cancer patient with abnormal labs, RBC L 2.93/HCT L 29.7/MCV H 102.5/Neutrophils H 73.4 who recently completed 10 days of radiation... the question is the Oncologist feels her labs prevent her from receiving chemo... He is basically saying she needs to go to hospice... The family disagrees and I suggest low toxicity Eribulin Mesylate to attempt to improve Overall Survival (OS)... Are we wrong for trying to keep her here? or is it time to let her pass as it is inevitable? Your thoughts please... specifically, the clinical side of attempting this compound or perhaps another with these lab results? Please advise

Answered by Dr. Prasanna Heijebu (5 hours later)

Brief Answer:
Chemotherapy can worsen blood counts

Detailed Answer:
Hi Sir

I can certainly understand your concern.

I worked through your query in detail.

She certainly has a very low count of RBC , that indicates anemia.

Chemotherapy can further worsen blood counts and can make an individual prone to severe infections.

Hence anemia can be corrected first before going for chemotherapy.

With regards to institute Eribulin, I would like to specifically know the exact form and name of the cancer with which she is currently surviving.

Based on that I will guide you appropriately.

This can also throw light on need of a hospice .

Thank you.

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Prasanna Heijebu (23 minutes later)

TNBC with mets in liver, lungs, sternum, and brain... Dx was 2012... Gamma knife performed Feb 2016... Just off of Taxol and radiation... My suggestion is low toxicity... Please review and determine... They usually give her a growth factor for anemia and she responds

Please look specially at compound, it's safety profile and + response in patients with TNBC

Answered by Dr. Prasanna Heijebu (5 hours later)

Brief Answer:
Risk benefit ratio of the drug should be considered

Detailed Answer:
Hello Sir

I can certainly understand your concern.

The response in patients TNBC to HAVALEN (Eribulin) has been pretty good .

But the main concern is it's safety profile.

The risk of side effects with this drug are pretty high.

The major side effects include lowering of neutrophil count along with severe peripheral neuropathy.

This drug is quite suitable in her case in my opinion.

But considering the risk of side effects, it's not advisable to institute the drug in her.

But under special circumstances this drug can be started after infusing G CSF (injections) to prevent neutropenia.

The decision has to taken after considering the risk-benefit ratio with the Oncologist.

Post your further questions if any.

Thank you.

Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar