Emily Ortiz27 said:I’m starting the AC chemotherapy protocol this Monday, so we’ve been doing quite a bit of prep work.
Most results look okay.
I could upload the images, but I don't want to clutter the thread since there isn't much else to see.
My hemoglobin has been steady for two months now, despite staying on my cycle and stopping the iron supplements.
Vitamin D is at 46.1, while the reference range is >75.
Everything else looks fairly decent.
However, my white blood cell count is hovering near the lower limit. It's at 3.8 (ref: 3.4 - 9.7). I'll find out what the doctor thinks on Monday; they mentioned I'd have a consultation before starting treatment.
The absolute neutrophil count is low (1.90, ref: 2.06 - 6.49), though the relative percentage is fine (49.8%, ref: 44 - 72).
The only other thing is that my glomerular filtration rate is low. This has been an issue for a year, and my specialist ran a mountain of kidney function tests, but nothing unusual turned up. An abdominal ultrasound from four months ago was also completely normal, just like always.
(eGFR CKD-EPI mL/min/1.73m2, GFR categories: G1: >= 90, G2: 60 - 89)
I also saw a cardiologist. They said everything is fine despite a slight murmur, noting it's normal and shouldn't interfere with treatment. EKG was normal. The ultrasound was also clear, aside from a note regarding the Doppler: mild mitral regurgitation and trace tricuspid regurgitation.
Hopefully, I won't crash and burn.
Hello,
To answer your questions in order:
1. Vitamin D — It’s clearly a deficiency. You should discuss this with your oncologist, as concentrations are expected to drop further during and after chemotherapy. Supplementation is standard in these cases, provided you consult your oncologist first and get their approval.
2. Leukocytes/neutrophils — As long as the neutrophil count remains above 1500/mcL (or 1.5x10*9/L), starting chemotherapy is not contraindicated.
3. Glomerular filtration — You didn't specify the exact value, but generally speaking, as long as levels are >60 ml/min/1.73 m2, there are no contraindications, nor is there usually a need to adjust medication dosages.
4. Cardiac Ultrasound — The findings you described do not suggest any barriers to beginning chemotherapy. The critical factor here is heart function—specifically the Left Ventricular Ejection Fraction (LVEF). With anthracycline treatments like the ones planned for you, there is a higher risk for patients with an LVEF < 50%. That said, cardiology isn't my specialty, so I won't dive into the granular details.
Wishing you all the best!
Good luck!