High ANC with chemo

Just wondering if anyone has experienced having high(er) ANC with 6MP and methotrexate? My daughter had labs done on Wed. this week and her ANC was 1900. I know that the goal is to get it under 1500, but it has not been under 2000 in months. Her onc. keeps increasing her dosages and this last appointment he looked a little nervous. I have read that higher chemo doses can cause liver problems or higher ANC could mean infection or relapse. I am getting more concerned :(

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My son has just been diagnosed with osteosarcoma (bone cancer) They are going to use high dose methrotrexate. This sounds like a drug with shitty side effects, whats your experience of it? Sorry I don't have any answers for you but I am here for support or if you just want to sound off about this awful nightmare were stuck in.

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Unfortunately I have experience in high ANC despite increasing dosage. My son ws dx with high risk T-cell leukemia, so the beginning protocol ws different with a lot more chemo and whole brain radiation in frontline, but LTM is pretty much the same. At about month 8 in LTM his ANC and his liver levels (ALT/AST) started rising. We struggled to get his ANC to the therapeutic levels. It ws very normal for his ANC to be over 3000 (and times when it was MUCH higher!) and yeah, I worried. We raised his 6MP and MTX as per his protocol but his liver levels and bilirubin would rise showing that his body was not happy. Testing shower that though my son does not have any of the three known mutations for 6MP, his body does not metabolize it. 6MP stays in his body eventually becoming toxic.

We would raise his dose, then have to lower it, for a while he was totally off 6MP to allow the liver to heal. It ws a constant balancing act. Our oncs said that it was important to have some 6MP with the MTX, even if a small amount as the drugs work synergistically.

The protocols are written to take all this into account. The good news is that my son has been OT for 18 months and though it took 7-8 months for his liver to go back to normal levels, he is doing well with no sign of relapse even with a non therapeutic ANC pretty much the entire last two years of treatment. (Cause I know that is the REAL unspoken concern and question :-O )

I hope this helps.

Nancy, mom to Dale, 16, dx with high risk T-cell ALL on 4/16/08, central and peripheral neuropathy, liver involvement, off treatment on 7/31/11 , www.carepages.com at daletall

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If you battling B-cell ALL, check out the CART-19 trial at Children's Hospital of Philadelphia (CHOP). If you have B-cell ALL and may be facing a bone marrow transplant, this engineered T-cell treatment is for you. Even if cure is uncertain, see if they can do a T-cell harvest now so they are ready to go in case you qualify.

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My daughter has TCell lymphoblastic lymphoma...her ANC went way up and they reduced her mercaptopurine (sp?) and her methotrexate. The ANC came back to a better level. Her liver counts were up at this time also....hope this helps.

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Thank you all for your comments. We have to back to have counts checked on Tuesday, so we'll find out how the increase has affected Ava. Then on Thursday we leave for Hawaii on her Make a Wish trip! Just hoping Tuesday goes well :)

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Hoping that things were good at clinic for Ava's re-check. And very excited for you for your MAW!! For what it's worth, Dale was on a chemo hold the weeks we went for his MAW. He had been inpatient 3 times over 6 weeks for liver levels and bilirubin. I was not at all bummed to not be on chemo when out of the country. It ended up being an amazing trip and I hope the same for you!!

Nancy, mom to Dale, 16, dx with high risk T-cell leukemia on 4/16/08, protocol AALL0434, liver involvement throughout tx, peripheral and central core neuropathy, OT 7/31/11, still very low IgG, but all in all doing very well , www.Carepages.com at daletall

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Hoping that things were good at clinic for Ava's re-check. And very excited for you for your MAW!! For what it's worth, Dale was on a chemo hold the weeks we went for his MAW. He had been inpatient 3 times over 6 weeks for liver levels and bilirubin. I was not at all bummed to not be on chemo when out of the country. It ended up being an amazing trip and I hope the same for you!!

Nancy, mom to Dale, 16, dx with high risk T-cell leukemia on 4/16/08, protocol AALL0434, liver involvement throughout tx, peripheral and central core neuropathy, OT 7/31/11, still very low IgG, but all in all doing very well , www.Carepages.com at daletall

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