Low white blood cell count

[cvms]

So I have been loving Tecfidera. I feel better than I have in a long time. I just had my first follow up with my neuro since I started Tec (on since beginning of June.) My white blood cells are low, my absolute lymphocytes are at 0.7 (bottom normal low is 0.9) and my hemoglobin has fallen below the normal as well. My doctor's nurse just called and said to recheck labs in December.

Has anyone else had this happen? I called active source line at Tecfidera and she said do what your doctor says. I just wanted to know if they found with the trials that people's WBC's dropped then stayed steady or kept dropping until they had to stop the Tec. She said she didn't have that information. Odd. She offered no help at all. Now I'm nervous my counts will keep dropping and I'll have to stop taking Tec.

Just thought I'd see if anyone else had low counts and if they stayed that way or what. Thanks!

[Marco]

I've had blood draws every two months even before starting on Tecfidera. When I first started my WBC counts dropped just a bit, but then recovered on the next test. I am not sure what minimum blood levels you need to maintain to remain on the medication. You might call the nurse back and let them know you are concerned and would like additional information from the doctor.

I have elevated liver enzymes, but my neurologist believes my benefits of therapy outweigh any risks at the current levels. We continue to monitor every two months and just take it test to test.

I hope things work out for you!

[shalimar]

Just had my blood test after 6 weeks on Tec and they were 5.3 which was us from 2.8 which was low from being on Gilenya for 2 years. Hope they stay up. My doc was happy with my liver enzymes too. Hope your numbers go up.

[MSer102]

The prescribing information for Tecfidera (that big piece of paper that comes with the medicine) says:

5 WARNINGS AND PRECAUTIONS

5.1 Lymphopenia

TECFIDERA may decrease lymphocyte counts [see Adverse Reactions (6.1)]. In the MS placebo controlled trials, mean lymphocyte counts decreased by approximately 30% during the first year of treatment with TECFIDERA and then remained stable. Four weeks after stopping TECFIDERA, mean lymphocyte counts increased but did not return to baseline. Six percent (6%) of TECFIDERA patients and <1% of placebo patients experienced lymphocyte counts <0.5x109/L (lower limit of normal 0.91x109/L). The incidence of infections (60% vs 58%) and serious infections (2% vs 2%) was similar in patients treated with TECFIDERA or placebo, respectively. There was no increased incidence of serious infections observed in patients with lymphocyte counts <0.8x109/L or 0.5x109/L.

Before initiating treatment with TECFIDERA, a recent CBC (i.e., within 6 months) should be available. A CBC is recommended annually, and as clinically indicated. Withholding treatment should be considered in patients with serious infections until the infection(s) is resolved. TECFIDERA has not been studied in patients with pre-existing low lymphocyte counts.

[hsmaldo]

I just got my results back from my bloodwork from my primary.

My lymphocytes were low (930) (min normal range I read was 1200) and my ALT (liver fxn) was slightly elevated.

She seemed to gloss over those until I told her I was on a med that could lower the lymphocytes and raise the liver fxn, so those were important to me!

She's faxing the report over to my neuro so he can have the info to look over. I'll ask more questions of him at my appointment next week.

Overall, I'm not too concerned, but will most likely ask to have my levels checked again in a few months...