Hello,
My son, Peter, is just on a bit of a chemo hold as his platelets are a little low. He is on cycle 8 of LTM for ALL.
I was just looking back over his blood counts since he started LTM, and discovered that his platelets always go low the week, or 2 weeks, after the LP. Other than those weeks, his platelets are always at a very healthy level. But with each progressive cycle, I can see that they dip lower and lower each time.
e.g. after cycle 6 LP they dropped to 79, after cycle 7 LP they dropped to 56, and after cycle 8 LP they dropped to 49.
They always recover by the next montly clinic visit, but I am just wondering how low they will be after the next few LP's . And I am especially wondering if anyone else has noticed this pattern.
Thanks for any info.
Bridget
I did notice that his ANC would always be lower 2 weeks after his LP's. With regard to his platelets, I did notice at times they'd get a little lower at his 2 week blood draw after LP, but not significant. We would never get blood drawn one week as he was on Dex that week as well and that would mess with his counts. I do have every record of his counts though, and I find it interesting that I can find patterns too. I think each child is different and that maybe that is how your son reacts to that chemo. Even though the IT MTX that they get in LP's isn't supposed to cross the blood/brain barrier, some does, of course, and that is the reason why they don't get their oral dose that week. Apparently, the IT MTX is a very strong dose and it is very probable that would mess with their counts...
I'm not sure. Elias has not had too much problem w/ plts. His is HGB. I will watch for that trend.
I just wanted to update this in case anyone else has the same problem. Peter just had his cycle 9 LP and we gave him the leucovorin at the required times after it.
His platelets dropped to 25 this time, even with the rescue drug. Now he's also in hospital with frebrile neutropaenia, so that is not helping his platelets, but I am guessing that his platelets would have been not much higher than 25 even without the fevers.
I asked the registrar why his platelets are lower after each successive LP and she said that it is quite common and is due to the methotrexate building up in their spines. Scary, and I'm not looking forward to his last 3 LP's.
Bridget