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Unable to maintain counts Nplate not longer working 2 years 8 months ago #69421

  • lisaknaack
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My father has been diagnosed 6+ years ago. Found Nplate to work up until now.
My question is has anyone found a successful treatment for years, then stop working for them all of a sudden?
- Levels have been 1-3 for 2 months, Drs working hard to find reason why
- Bone marrow test came back negative and ITP is reason platelets are low
- Many transfusions and treatments
- Hospitalized last night with 0 count and 101 temp. He has not had a temp until last night. Don't know where infection is but they are treating with antibiotics.
- Test negative for COVID

Oh, the old coot is 89 years old and spirits are up but no energy at all. He is a wonderful, funny, fighting survivor and will see the age of 100. Looking for your help when your treatment stops working.

God bless everyone and I am very grateful to be a part of the PDSA group. This group was my rock when he was first diagnosed and thank you for everyones insight and support.

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Unable to maintain counts Nplate not longer working 2 years 8 months ago #69453

  • Hal9000
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  • Give me all your platelets and nobody gets hurt
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lisaknaack, though I myself have not experienced a loss of response, from reading posts here, loss of response to a particular ITP drug appears to happen fairly often. Since there are 4 known antibodies which can possibly contribute to ITP, it is a plausible projection that the situation might be that he has gone from one bad antibody to two bad antibodies contributing to lower counts.

Having said that, it is also quite possible to just experience a change in response that can be compensated for by merely increasing the dose, the dose of Nplate in this case. Nplate doses are normally expressed as an integer from 1 to 10 and represent the amount of the drug divided by one's weight in kg. For example, a '5' dose would be half the max dose of '10'. So, perhaps just an increase in dose was required here, yes?

On a covid19 side note. As I understand, one can get an ongoing idea of its active presence from a full/complete blood count test, aka CBC - which occur all the time with ITP. Covid19 causes out of range low red blood cell count (RBC), with normal RBC morphology, and an out of range Hemoglobin, either out of range high or out of range low. If white blood cells eventually fall through the floor, then that would be a very, very bad indication.

How is he doing?

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