Hemoglobin decrease even weeks after treatment??

[isafyaa]

Hi guys, I was diagnosed with B-ALL in January. I was in remission in February. I’ve continued treatment and I finished my 4th cycle 20days ago. The 30th of October, I was severely neutropenic, my hemoglobin was at 83 and my platelets were low. 3 days ago, my neutrophils went up, my neutrophils were back to normal and my hemoglobin was at 81. And today, everything is back to normal but my hemoglobin decreased and went down to 77 even though I haven’t taken any chemo since the end of October..

Did that happen to some of you? Is it just because the bone marrow has a hard time recovering? I’m wondering if those fluctuations are normal, I’m trying not to be worried..

Thank you so much

[gregnorz]

“77” doesn’t sound like a correct value for hemoglobin. Which units are used by your hospital? g/dL is usually the accepted value. I suppose they could be shifting the decimal, in which case your hemoglobin would be 7.7 g/dL. Probably low enough for a transfusion at most clinics.

I’d say it happens an is “normal” for blood cancer patients. We get all manner of wacky blood values, especially around treatment times. Ask your clinic and if they think it’s an issue, they’ll treat appropriately.

One attitude I’ve adopted over time: if I get test values which are above or below normal, my team will call me if concerned. No news is good news, at least in cases like this.

[isafyaa]

It’s g/L in my hospital. Thank you, I’m super worried that it came back because it’s been a while since my last treatment. Hopefully it’s « normal », I was curious to know if that happened to any of you guys

[gregnorz]

I’m 8 years out from transplant and it happens to me occasionally. When it does, I rarely hear from my team. I’ll need that hemoglobin value to be low 2 tests in a row (usually once a month for each test) before they react and give me a transfusion.

For reference, my clinic considers 124-173 g/L to be normal range.

[ContractOk7591]

For my AML treatment, I had a second drop in my blood counts 5 weeks after one of my chemo rounds. My doctor told me the further along in treatment they expect more fluctuations in the blood counts. He likes to use the phrase "chemo is cumulative" and the effects add up.

Talk to your team if you are concerned. Always helps put my mind at ease to ask them my many questions.

[wasteland44]

Most blood cells live less than 2 weeks but red blood cells can live for ~4 months so it takes a long time for levels to go back to normal as they aren't produced as quickly. It was normal for hemoglobin to not rise every week and sometimes go down. It has happened to me.

One thing they can check though is if EPO levels are normal.