Platelet Disorder Support Association

Join Us:

Become a Member

Support Us:

Make a Donation
    Remember Me     Forgot Login?   Sign up   •  Web site Help & Info
!!! DISCUSSION GROUP RULES !!!

1. You must be a registered website user in order to post and comment. Guests may read only.
2. Be kind and helpful, not rude and cynical.
3. Don't advertise or promote anything. You will be banned from the group.
4. Report problems to the moderators. THANK YOU!

overlapping treatments

More
15 years 4 months ago #5150 by jtx
overlapping treatments was created by jtx
What are the general thoughts about overlapping therapies? My dr. mentioned that you have better shot of effectiveness if you overlap a new treatment with the previous one while the counts are higher instead of starting the new treatment after the counts have crashed. But how will you know if the first therapy has worked if you don't give it a chance on it's own?

Yes, my counts are dropping on pred as I taper, but maybe they will stabilize. Last week I was at 50 (on 30 mgs). It looks like some people are staying on pred while they try other treatments...is that just while they taper off of pred, or do some try two treatments together? Not sure if I am explaining this right. I just don't want to go through cost and side effects of new treatment if my counts don't actually crash. But my dr. feels like they will.
  • Sandi
  • Offline
  • Sandi Forum Moderator Diagnosed in 1998, currently in remission. Diagnosed with Lupus in 2006. Last Count - 344k - 6-9-18
More
15 years 4 months ago #5154 by Sandi
Replied by Sandi on topic Re: overlapping treatments
It depends on which treatments you use at the same time.
More
15 years 4 months ago #5163 by eklein
Replied by eklein on topic Re: overlapping treatments
I don't think your doctor's opinion is based on research but maybe on his personal experience with patients. I've never heard it before. It has an intuitive appeal - I always think about not letting my spleen 're-learn' how to gobble platelets, but that's not really science. So, more like a hunch. There is research though that combining certain treatments can be more effective than each treatment alone, in particular I think they combine dex with some of the others (Rituxan?).
Erica
And she was!
Diagnosed May 2005, lowest count 8K.
4/22/08: 43K (2nd Rituxan)
10/01/09: 246K, 1/8/10: 111K, 5/21/10: 233K
Latest count: 7/27/2015: 194K
More
15 years 4 months ago #5170 by Ann
Replied by Ann on topic Re: overlapping treatments
I'm with you jtx, got to see what a treatment does before using the next and maybe the count will stabilise somewhere. But at the same time it is sometimes necessary to use steroids as a rescue medication while waiting for some of the slower acting drugs kick in.
  • server
  • Offline
  • newcreationchangingdaily
More
15 years 4 months ago #5171 by server
Replied by server on topic Re: overlapping treatments
I'm on NPlate and Rituxan. I asked last week how they would know if the Rituxan is working because it's currently the NPlate that is keeping my numbers up. The nurse said my other blood work will show if it is or isn't working. I think I'm going to say no to NPlate this week though. I wanna see for myself just through my platelet count.
My flesh and my heart may fail, but God is the strength of my heart and my portion forever.
Psalm 73:26
Blessings,
gretchen
More
15 years 4 months ago #5183 by Ann
Replied by Ann on topic Re: overlapping treatments
Be careful coming off Nplate. It can cause a sudden massive drop. I had awful bleeding symptoms when I missed a week (not my fault, they didn't have the drug).
  • server
  • Offline
  • newcreationchangingdaily
More
15 years 4 months ago #5187 by server
Replied by server on topic Re: overlapping treatments
On the 14th of May my count was 287 so I didn't get the NPlate that week. On the 21st I was at 200 and got the shot. on the 28th I was at 125! Is there a chance the NPlate and Rituxan are not a good mix? I dunno. there are so many factors with meds and "that time" and on and on and on! I'm getting over-whelmed!
My flesh and my heart may fail, but God is the strength of my heart and my portion forever.
Psalm 73:26
Blessings,
gretchen
  • Sandi
  • Offline
  • Sandi Forum Moderator Diagnosed in 1998, currently in remission. Diagnosed with Lupus in 2006. Last Count - 344k - 6-9-18
More
15 years 4 months ago #5189 by Sandi
Replied by Sandi on topic Re: overlapping treatments
Gretchen:

I don't think there is enough research on using Rituxan and N-Plate at the same time to know about safety issues. Logically, the only issue I can think of would be a clotting risk.

I'm curious to know how they can tell by your blood work which one is working. That should be a good explanation.
  • Sandi
  • Offline
  • Sandi Forum Moderator Diagnosed in 1998, currently in remission. Diagnosed with Lupus in 2006. Last Count - 344k - 6-9-18
More
15 years 4 months ago #5190 by Sandi
Replied by Sandi on topic Re: overlapping treatments
JTX:

Some drugs are used together and referred to as "cocktails". Those are generally used when a person does not respond to any one treatment alone. There are also drugs that are used together like Ann said - using Prednisone while waiting for Rituxan to kick in. It's not unheard of to use two at a time, but sometimes it's not the best idea.
  • server
  • Offline
  • newcreationchangingdaily
More
15 years 4 months ago #5193 by server
Replied by server on topic Re: overlapping treatments
I thought of that too. I wish I understood what all of the bold print with High and Low next to them mean on my CBC. I know what the High and Low mean, but I still don't get what MCV and MCH and Neutrophils and all the other big words mean! I've tried to research it, but I just get lost in the process. Guess I gotta get more serious about it if I'm ever gonna understand it. I surely will have a list of questions for my doctor on my next visit on June 16th.
My flesh and my heart may fail, but God is the strength of my heart and my portion forever.
Psalm 73:26
Blessings,
gretchen
More
15 years 4 months ago #5199 by Ann
Replied by Ann on topic Re: overlapping treatments
My take on it.. with no proof but just mulling it over.. they can tell if the Nplate is working by looking at the size of the platelets. A high MPV (mean platelet volume) would mean lots of large, new platelets. A lower MPV would mean some are smaller and therefore older which would mean that the rituxan is working and allowing the platelets to live longer. If both drugs are working then you'd have a lowish MPV and lots and lots of platelets.. in that case you'd lower the Nplate dose and end up getting off it altogether.

That all sounds quite sensible. The only problem is as Sandi says, that in the meantime, the high platelets with lots of new ones could cause clotting.

Which things on your blood listing are high and low? Try this site for explanations. www.carbonbased.com/Definitions.htm
More
15 years 4 months ago #5207 by lili
Replied by lili on topic Re: overlapping treatments
They can tell if the rituxan is doing what it's supposed to do. That is, they can do B cell counts to see if the appropriate B cells are being killed off. That may be some of the numbers that Gretchen's seeing. However, I don't really see how they can tell if the rituxan is getting the platelets up or if it's the Nplate, unless there's evidence that when rituxan fails in ITP, then it fails to destroy the B cells.

Lily
More
15 years 4 months ago #5211 by Ann
Replied by Ann on topic Re: overlapping treatments
Like I said, they can tell by which platelets are there. If there are some older ones then they obviously aren't being killed off so the rituxan must be working. The MPV would indicate that even without them looking at the blood smear. I actually had similar when on Nplate and then taking steroids. I've refused to take steroids again but did that once and the high count had a lowish MPV so we knew that it was the steroids causing the high count.
  • server
  • Offline
  • newcreationchangingdaily
More
15 years 4 months ago #5212 by server
Replied by server on topic Re: overlapping treatments
my MCV and MCH are low. Neutrophils%, and Absolute and Eosinophils% and Absolute are all high. And Anisocytosis is present.
If I'm having any clue of what any of this means I'd say I'm still anemic, I'm fighting some kind of infection and my RBC's are abnormally sized. I dunno!
My flesh and my heart may fail, but God is the strength of my heart and my portion forever.
Psalm 73:26
Blessings,
gretchen
More
15 years 4 months ago #5218 by Ann
Replied by Ann on topic Re: overlapping treatments
Yes anaemia would account for all the red blood cell stuff. High eosinophils is usually to do with allergies or allergic asthma. But it depends how out of wack these things are. On the high side and they tend to get ignored. My white count is always low and nobody has ever bothered about it.
  • Sandi
  • Offline
  • Sandi Forum Moderator Diagnosed in 1998, currently in remission. Diagnosed with Lupus in 2006. Last Count - 344k - 6-9-18
More
15 years 4 months ago #5222 by Sandi
Replied by Sandi on topic Re: overlapping treatments
I can't remember the last time my CBC results were ever normal. My whites are always out of whack, reds sometimes. I never worry about it. The only time I did was when my lymphocytes were very high and flagged as abnormal. They eventually returned to normal.

Lili - they can do a B cell count, but I don't see that done very often.

Ann - the MPV sounds reasonable, but mine have always been all over the place with no reasonable explanation. I'll have to see if I can find my blood work from the Rituxan days and see what it was.
Platelet Disorder Support Association

Donate

About

Stay Informed

Follow Us

IMPORTANT!

The Platelet Disorder Support Association does not provide medical advice or endorse any medication, vitamins or herbs. The information contained herein is not intended nor implied to be a substitute for professional medical advice and is provided for educational purposes only. Always seek the advice of your physician or other qualified healthcare provider before starting any new treatment, discontinuing an existing treatment and to discuss any questions you may have regarding your unique medical condition.


Platelet Disorder Support Association
8751 Brecksville Road, Suite 150, Cleveland, Ohio 44141
Phone: 1-87-PLATELET | 877-528-3538 (toll free) | or 440-746-9003
E-mail: pdsa@pdsa.org


© Copyright 1997 - 2025, Platelet Disorder Support Association. All rights reserved.
The Platelet Disorder Support Association is a 501(c)3 organization and donations are tax deductible to the fullest extent allowed by law.


Privacy Policy and Terms of Use