KISQALI
I have completed one cycle and am on week off in 4 days I’m supposed to be back on My blood numbers tanked like worse than in chemotherapy My white blood cell count is 1.8 platelets 130 Will they pull me off medicine? I was in getting my fulvestrant shot not at same clinic as my onocologist so nurses were unable to answer The other thing I was wondering is will my numbers get worse with time or is this my body adjusting? What will happen if I can’t have KISQALI? I hate cancer so much but I have met so many good strong wise people going through this I mean really good people I’m really questioning if I should have stayed with second opinion doctor while still maintaining current onocologist I will get scans done at one location and my current onocologist will prescribe medication
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Others can correct me if I'm wrong, but I believe the cutoff for white blood cell count is 1.0 before they will either hold the Kisqali for an additional week or contemplate a dose reduction. My wife hovers just over that 1.0 threshold and has since she started on Kisqali right about 2 years ago now. She was under once early on in her therapy and they withheld it for an extra weeks to let her counts recover. Those persistent low counts have not appeared to have any adverse consequences (no recurring or more frequent sicknesses or infection or anything). Kisqali suppresses some normal cell function too in addition to suppressing cancer. So that is why low white blood cells is one of, if not the most, common side effect. The good news is that even if they have to lower you dose because you are chronically below the threshold, the results from the lower doses seems to be as effective as the results from the higher doses.
Others can also chime in on ways to "artificially" increase you white blood cell count right before your blood is drawn too so you don't have to worry as much about being under the line. Some vigorous exercise shortly before the blood draw, and eating dark chocolate are apparently two pretty reliable ways to give it a boost.
Hope that helps.
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@ilovewhales If low white blood cell counts persist, your dosage may be dropped. This happened to me, and I've been on the 400mg of Kisqali for 10 cycles. If you are responding to the medicine, the overall survival rate is the same even at the lower dose. It seems alarming at first, but I actually felt physically better on the lower dose. I tried exercise, chocolate, all that, to try to raise my count, but nothing helped. One thing you might try is to make sure they do your blood work at the end of your week off from Kisqali when you blood cell counts have rebounded. I am doing fine on the lower dose. As my oncologist explained, the key is to get the right dosage that works with your body.
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the portion of the white blood cell count that they look at is the ‘absolute neutrophil count’ or ANC. Usually about half of the total wbc number and tends to be lower in winter months. This drop tends to stabilize as you spend more time on this med, and doesn’t appear to carry the same infection risk as low WBC’s during traditional chemo might.
The big indications to stop this med are inflamed liver, prolonged qt interval on a heart tracing (ekg), and lung inflammation (pneumonitis). Also, I think you’re only at day 4 off? They want anc > 1.0 on day 8 (ie the day you’re due to start the next cycle) - so you still have a few days for your numbers to come up.
typically a few things happen to deal with low counts - lower dosage and/or alternate schedule with more time off (instead of the usual week).Sounds like you’re still very early to know where things are going to settle, so try not to lose hope about this med!
Hope this helps!
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Thank you so much I do feel so much better and hopeful great pertinent information Your answers have provided relief
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Hi
I tanked on kisquali after 4 months . I changed to abemaciclib which Oncol warned could have worse effects and I'm 1 year+ on this & bloods/side effects improved massively. I also reduced carb/sugar intake at same time & it's going really well. Everyone's body is different, so don't fret. You have options of switching cdk's.
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