RBC levels

[maggiemag]

Hi Everyone,

This may be a lame question, but I’m gonna ask it anyway!

I know that physicians go by the hemoglobin level when they order transfusions. Since I am very early in the disease, I have not yet required a tx. I am still mildly anemic although refractory. My Hb has never been lower than 10.8 and I am now at 11.1. My question is: how low does the RBC level get before it is worriesome? Does only the Hb matter as far as tx? My RBC level now is 3.1; is that mild or moderately low?

Thanks in advance for any insight!

Mags

[marlene]

Mags,

Most consider doing RBC transfusion when the HBG is around 8. But you also have to take into consideration symptoms. Some need to be transfused sooner because they are symptomatic while others can go lower with no problems. And yes, it’s the HGB and hematocrit they use to determine transfusion requirements…how much oxygen carrying cell you have as well as the volume of blood.

John always had a transfusion goal for platelets and red cells. In his case, a HGB of 8.3 was his threshold. This is pretty typical. For platelets, it was 8K. John’s HGB dropped down to 5.5 just before he was diagnosed and he was still walking around. Had a major headache but he got around.

[maggiemag]

Thank you, Marlene. I do know what level of Hb requires a transfusion. I already have CHF, so the heme told me I would probably need blood at 8.5. I was just wondering what that translated to as far as the RBC level. Is mine mildly low or moderately, at 3.1?

[Zoe]

Mags,

Labs vary somewhat on what they consider normal. However, RBC low end normal should be between 3.8-4.2 ish. My RBC runs around 2.7-3.1 lately, and my hgb is running in the low 10’s. But as Marlene said, they really look at hgb and hct for transfusions.

Zoe

[Hunter Bob]

My dr orders a blood transfusion when my hemaglobin is at or below 8.5.

Hunter Bob

[katydid]

I have a transfusion when I am about 9.1 – was 8.9 this last time but really felt it – doc said that is about normal for a tansfusion low 9’s to early 8’s – I was severely symptomatic by 8.9

ps Zoe , Mags – am here quietly xx c

[plantcollector]

I lived for many years with a Hgb in the 8s. I felt pretty good, and have always considered myself fortunate. Guess my body compensated in some way. Last year the Hgb counts started dropping, and I required transfusions. I do okay at a low number, but now am getting transfusions when the number goes to about 7.5 or lower. I have had a low of 5.9, and sure was walking around. The stairs get difficult at that level though. Was hopeful that Revlimid would help, but think it will be discontinued soon. Guess I am a 5q- patient not helped with this drug.

[Kenneth_In_Va]

Hi Plantcollector,
I am sorry to hear you had no luck with Revlimid. Did you wind up discontinuing?
I just began with it last week and will be going in for my 1st CBC since then next week. I too am hopeful.
Do you have any other chromosome abnormalities orthe than the 5q-?
Thanks, and best of luck to you.

[plantcollector]

Hello Kenneth. Yes I just stopped Revlimid on November 18th. It was not doing anything for me, and it is possible that the problems with my gut were being caused by Revlimid. I could not "pin" it on anything else. The 5q- is my ONLY chromosome abnormality, so I was hopeful that Revlimid would work for me. I have been transfusion dependent since last Fall. After the 1st of the year I guess it will be on to Vidaza. I know that it takes maybe as many as 4 rounds to see any results. But I could put that on hold for awhile and rely on transfusions. I have been getting RBCs about every 4-5 weeks. I rarely get a transfusion unless my hemaglobin is under 7. My body has adjusted to the low counts since 2001. I am lucky. Actually I have been down to 5.9 and not really felt the effects very much. Hope to hear from you as to the results of Revlimid. I know that many have had good results. But it is not 100%, of course. And some do not see any results for quite awhile. I am sure that you know about the problem of blood clots with the drug. So watch that. I developed a couple in my leg after taking the drug 3 months. I was off for awhile and went back on it at the 5mg. level for a couple of months. Then in July I went back at 10 mg. Still no results. Good luck. You just might be one that does well with that. I sure hope so! Sylvia

[gini]

hi mags,

My husband has had 13 transfusions and we are always told if his hemaglobin goes below 80 he needs to be transfused as male hemoglobin should be 140 to 160 His MDS is low red blood cells. His marrow is no longer producing it. I don’t understand the counts you are saying 10 or 11???

dee

[lindajo]

Levels are slightly different for men than women. They also move a decimal point on counts from Canada. I recommend that you get a copy of your blood counts and next to the levels should be what is normal or considered normal.

Keep track of how fatigued your husband feels at that level. I rank myself from excellent, good, fair or poor. Also make a note of other symptoms such as cold, flu viruses, stomach or pain problems. If you keep score yourself you will get an idea or when a transfusion might be needed.

Only your husband can tell the doctor how he feels. The doctor will make a recommendation dependent on what the patient tells him or her.

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