This particular chemo - Gemcitabine (gemzar) is notorious for knocking back your blood counts. Really, any chemo can cause low counts, some are worse than others, and we are all different so what knocks mine back may not do the same to someone else.
Last week my counts were low and so they gave me just 50% of the standard chemo dose. My white blood count was 1.76 with the low end of normal at 3.98; my red blood count was 2.4 with the low end of normal at 3.93 and my hemoglobin was 8.2 with the low end being 11.2.
We were pretty sure that even the 50% dose would cause even lower levels, which is why I was scheduled for labs yesterday. And that is what happened - my red blood count went down to 2.21 and my hemoglobin dropped to 7.6. My platelets were down to 51 with the low range at 150. So there was no question that I needed the transfusion - I think hemoglobin below 8.0 is the criteria. And I couldn't walk even a few steps without being out of breath, so it was a no-brainer decision.
They called the blood bank and requested two units and the blood was couriered over to Dana Farber. It arrived about 1 p.m. and it took about 3 hours for the transfusion. I have to say I felt much better after the treatment. When they started the transfusion, my bp was about 102/47 and it was up to 112/65 when it was finished. And my heart rate was 100 when we started but went down to about 78 afterwards.
So that's the story. My next dose (next Wednesday) will probably be at about 80% of the full dose - I'll not be able to have a 100% dose again because it would be dangerous.
The good news is that I think it's working. My cough ( probably from lung mets) is pretty much gone. We were thinking about adding abraxane to the mix but we're going to hold off as it would add to the blood count problem.