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Blood counts suppressed by pelvic external beam radiation tx?

zsazsa1
Posts: 225
Joined: Oct 2018

I'm almost done with pelvic external beam IMRT, just one more treatment to go.  Today I was in for Herceptin, and they did a CBC, Chem 20, and Ca-125 before my infusion.  All that came back before I left was the CBC.  I was very surprised to see that my platelet count, which had been low from chemo, but had always bounced back, was low - about 82K.  And while chemo made me anemic, that too had always bounced back - but here it was low, with a Hgb in the mid 10 range.  My WBC was on the low side, too - 4.0, with 2.7 neutrophils.

I have been afraid all the way through that the radiation is being aimed too high - it seems to me that the device is over my abdomen, rather than my pelvis.  I've expressed my concerns repeatedly, and they keep reassuring me that it is being done correctly.  But now, the only explanation that I can see that all three cell lines are down is that it's affecting my bone marrow.  And the IMRT to the pelvis is not supposed to be doing that.

Either that, or I've got leukemia or preleukemia - which could certainly happen years after chemo and radiation, but not this fast! What I'm hoping is that this is just a temporary side effect of correctly aimed IMRT to the pelvis, but it doesn't make any sense.

Has anyone had this happen with pelvic external beam radiation that was aimed only at the pelvis?

suzycruise76's picture
suzycruise76
Posts: 24
Joined: Mar 2019

I have a different cancer (colorectal),but I recently finished my chemo and radiation,and my last CBC results have been more than concerning: hemoglobin,RBC,WBC,platelets,lymphocytes-all abnormal=very low. RDW abnormal=high.

I had a chance to discuss it all with my oncology dr., who had not been concerned and explained to me that blood mostly "repair" itself in a few weeks post radiation,and I can help it by eating the right food (for ex.red meat,chicken,fish,legumes and dark leaves vegetables). I definitely feel the lack of RBC and hemoglobin in my blood,which makes me very tired,but I hope it will slowly recede and I am going to have more energy soon.

I believe that your case is going to be similar to mine,and your dr. will help you to find your peace.

All the best,

Suzy

 

barnyardgal
Posts: 167
Joined: Oct 2017

My counts were low after radiation. I was surprised but the doctor said that was normal. 

MAbound
Posts: 723
Joined: Jun 2016

My blood counts went down dramatically during chemo but always seemed to bounce back in time for the next infusion. Radiation was different. Everything seemed to go down at a steady pace and stay down. It took almost 6 months after chemo for them to get back to normal, so you may have to expect the tiredness and increased susceptability to infection to continue for a while after you finish.

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LisaPizza
Posts: 168
Joined: Feb 2018

Rads had no effect on my blood counts,  but I know from my reading that it definitely can. 

Violet123
Posts: 26
Joined: Nov 2017

Depending on where they are aiming the radiation beam, I believe bone marrow can be affected which can affect blood counts. There is a large portion of bone marrow in the pelvis, spine and ribs, as well as the top of the thigh bone (femur).  My counts were affected by the chemo followed by 25 rounds of radiation.  My oncologist asked if my spine was sore.  He said that the bone marrow in other locactions work harder to produce blood cells.  When I had to have the Neulasta injection, my spine and ribs were so painful, even with taking the Claritin everyone recommends.  I wonder if the pain was due to the bone marrow kicking into high gear to produce the cells I needed.  My oncologist only prescribed Neulasta once.   while receiving pelvic radiation they never tested my blood counts Except for ca125.  A year after finishing treatment, my annual regular physical blood test showed my WBC count was low.  My MD said that may be my new normal with the treatment I received and they would keep an eye on it.

Ribbons
Posts: 38
Joined: Jan 2019

I finished chemo on Feb 15th and finished 3 brachytherapy treatments on April 1. I had a blood test yesterday and I was surprised that my neutrophils are lower than they have ever been! On my chart, the lowest normal for neutrophils is 1.50 and mine were 1.59. My WBC was slightly below the lowest normal. I was surprised by this, as I expected everything to be higher by now. I guess it takes a while from reading on here. I do still get tired sooner than I think I should.

Sunrise19
Posts: 15
Joined: Apr 2019

I was just about to write an update and new (to me ) question when I saw this. The 3 brachy treatments did not seem to impact my blood count, but i'll need to double check. I did not feel the fatique that I do now. So, have completed 4 chemo treatments, Carboplatin and Tax. By treat 3, the bloodwork had dropped so was given a Neulasta typ generic, and was within limit for treat 4. However, the next bloodwork showed very low platelet level. No chemo advised but to wait a week. Following week the same. Now I am to get another bloodwork next week... will post my new question...

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