n-plate

I have been on N-Plate for 18 months. I started out with a shot every week for a few months and then have been on a shot every 2 weeks for about a year. My platelets would stay between 70-150 most of the time but in the last month they have dropped dramatically to 47,000. I can't figure out why...does it stop working after a while, is it something different I am eating or doing? I am also very tired most of the time. My doctor doesn't really give me any answers and I am really frustrated because I thought I finally found something that works and didn't have to think about it all the time! Did anyone else have this experience or know what went wrong?

Marg:

When a person is on N-Plate, counts are supposed to be maintained around 50k because of the risk of blood clots. 47k is actually exactly where it should be. Seems to me that it's still working.

I wouldn't worry about the drop; that can happen and it doesn't mean that it stopped working. If you would continue to see a downward trend and it would hit a count below the safe range of 20k, then you might need to look at a dose adjustment.

Thanks Sandi! Since my counts were always so much higher I thought this was bad. I also take the highest dose (10) and am so afraid that they will go down lower. I have no symptoms except tiredness. The only thing my doctor could change is the frequency (once a week)! Thanks for the encouragement though. I hate to think about taking prednisone again or the IVIG I was doing every 6 weeks! UGH!

My experience with Nplate is that it does go up and down but it is the general trend that is more important. Give it a while and see what happens.

Why does your doctor change the frequency rather than the dose? That is not the norm. What happens when you take it weekly?

My doctor hasn't changed anything yet, but the nurse said maybe he would change the frequency because I am already at the top dose. I have a feeling if it's at 47k when I go in 2 weeks, he might not do anything. I'm just nervous about it and think about it too much!

Your story could have been mine. 18mths Nplate and then the drop. I was in a state for some days/weeks until I gave myself a reality check - at least it wasn't below 20K, and I had a minor infection which may have been responsible. A blood count a few weeks later showed that it was back to "normal" - what ever that is!!!