Haematology

Platelets were for the first time within normal limits at 435, but Hb, WBC and Neutrophils were all down and outside normal limits. Mr G O, who saw me 8 WEEKS Ago and again this time,said that my tiredness was possibly a reflection of the low Hb, and the problem was that increasing the dose of hydroxycarbamide, which had corrected the Platelets,caused the other three components they monitor to move in the wrong direction. At this stage the only thing the consultants are interested in is juggling the medication to get the best possible mix of the four numbers, and as long as they remain within sight of target levels nothing else seems to matter and alternative forms of treatment are not being considered. If the HB drops too low there are two alternatives that can be considered: injections of erythropoietin, a protein that stimulates production of Hb in the bone marrow, but has side effects including greater likelihood of thrombosis; or blood transfusions. Neither of these solutions is permanent, of course.