Results from Aranesp? How long?

[josey]

I have had my 3rd shot of Aranesp. How long before I see any results? My Hgb has come up a little as has by wbc, but platlets still running from 10,000 to 15,000. Had my first nose bleed yesterday, I got very upset at by 89 year old ex mother in law that I help take care of and felt my blood pressue going up, next thing I knew I had a nosebleed. Not a bad one, it just wouldn’t stop, platletts are at 10,000 now. Anyone had expierence with Aranesp?. I notice there are more caregivers on this forum than people that actully have the disease. I don’t have any family that will on here for me, so I am afraid you will become my family when I need advice and help. Thanks for any input. I worry about a sudural hematoma and not being able to tell if i have one or not. Any answers on the Aranesp of subdural hematoma’s would be appreciated. Joanne forgive the spelling but I am not quiet awake yet. Joanne again

[Aleksandra Poland]

Josey,

I hope this helps a bit for the beginning. I’m sure there are people here who have much more experience with the treatment.
We got these hints on Aranesp from the doctor in Vienna that I visited last December – “our” MD had no experience with this medicine, since it’s “too expensive to apply in our hematology clinic”.
The suggestions from Vienna were as follows:
> erythropoetin (Aranesp, Erypo, Neorecormon etc.) influences only the level of RBC in the blood, in the way pushing the reserves from the bone marrow towards the bloodstream) > it has unfortunately no influence on PLT/WBC, but it may become an alternative to the RBC transfusions
> it is necessary to check the erythropoetin level in blood serum before the medicine is administered (only if the level is below the norm, erythropoetin may bring some benefits)
> the dose should be at first 2,25µg/kg body weight 1x/week (approx. 150µg injection for 79kg), in 4 weeks the results should be evaluated and in case they are no satisfactory, for further 4 weeks the dose should be doubled (than a check again)
> there is a warning about combining erythropoetin and G-CSF (this can in certain cases speed up the progress of MDS towards AML)

My Mom got only 3 minimal doses, and after that got into the hospital with an infection, where they got all scared and administered several RBC/PLT transfusions, so we could not really see any effects of Aranesp. I hope you will soon feel the results – all the blessings to you,
Aleksandra

[Neil]

It can take 4-6 weeks before there is any increase in RBC/HGB. It varies from patient to patient.
You probably won’t see any change in WBC or Platelets. There are some rare instances where the marrow is stimulated enough to trigger the production of WBC/Platelets but very rare. I had some spotty increases in WBC/platelets when on Procrit, but only for a day or two after the injection. Counts were back to my “normal” range by the time I was ready for my next injection.
You might be able to help WBC with neupogen, but there are no drugs that will increase platelets for any extended period of time.
Some patients get a platelet boost from Danazol but it is temproary and they frequently return to a lower level after stopping (Danazol). Some respond to steroids such as Prednisone, but the side effects are pretty nasty and it again is temporary.
There are one or two drugs in phase 1 trials. Have been waiting for some info on how effective they are, but will probably be a year or two before anything conclusive comes out. Lonafarnib might be the most promising at the moment. Trials are being conducted at The Univ. of Chicago. Contact is Margaret Green 773-702-0267. AMG 531 is another drug being studied at The Univ. ofChicago

[josey]

Thanks, I havn’t seen much improvment in my hgb counts yet. My doctor mentioned a new drug for platlets, I don’t remember which one that she thought I might be a canidate for a trial with, she was going to check into it. Its my platlets that give me the biggest problem. I can handle a hgb of 8.4 and a wbc of 2.7 without much problem. Will email her to see whats going on, she is at Oregon Health and Sciences University. Josey

[bety]

My husband was on aranesp for about 3 years, after which it stopped working for him. He has become tx dependent. Also, his wbc and platelets have dropped to very low levels. Recently, he has been suffering from nosebleeds. I have noticed that the bleeding seems to be exacerbated when his blood pressure is elevated. Keeping the systolic pressure below 140 seems to help.
……..
husband, Ed, 87, Rars, pancytopenia, tx dependent 2-4 weeks. Is quite pale, feels very cold, but otherwise has a fair amount of energy.

bety

[josey]

bety, I noticed that about nose bleeds myself. If I get really upset and feel my blood pressure go up I get a nose bleed. Luckily they have been pretty mild, but it is something I watch out for more now. Thanks Joanne

[bety]

Josey, I hope you are being treated for your occasional hypertension. Ed and I monitor our b/p twice per day with a wrist sphygmonometer (not the most accurate). I try to keep his diastolic below 140, but he does not always cooperate. When my b/p was out of control, I found that exercise, weight loss, low salt intake and medication kept it within bounds. Celery has a relatively high salt content but is a natural diuretic which helps me keep my med. dosage on the low end.
Please consult with an md regarding your b/p. I am not an expert, but I try to keep up with the literature. This forum has been a tremendous resource. I try to check it daily. All the best, bety

[Caroline]

Josey.

My Dad saw results after his first shot of Aranesp. He received 150 units. His hemoglobin went from 100 to 148. That was too fast and too high an increase for his heart. As the hemoglobin count rises, the blood becomes thicker and stickier. Therefore, the heart has to work harder to pump the thicker blood. Dad went 3 months shot-free to let his hemoglobin drop again and then began 80 units once a week. Again, his hemoglobin went from 100 to 140. Weekly shots were too much for him. He got another break from shots until his hemoblobin dropped to 120. That is where his Oncologist wants to see his hemoglobin stay. Now I give him a shot once a month. He gets 80 units per shot. His gemoblobin is usually 120 when I give him the shot. It rises to 140 or so and it takes a month to drop back down to 120. So far he feels good and has some energy.

As far as your nosebleeds…even though it is practically impossible in this society…TRY to avoid stressful situations. The last thing you need is to lose blood.

Blessings,
Caroline

Caroline

[Author]

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