Blood work while on Keytruda/PD-1

Well I think anemic is when the hemoglobin is low. On pd1 mine slowly went down. Then they added abraxane and it had a larger drop. So they plan to give me blood if it drops again. But they said it had nothing to do with iron or anything with my diet. For me it was the abraxane although they never explained why my hemoglobin kept dropping slowly on pd1 just that my platelets were good so I was ok. Your doc should be able to explain what pd1 causes in blood work. They did for me but I don't remember all of it. When I say slowly it took over a year to drop into the red then with abraxane a larger drop in the red.

For white blood cells that is difficult to answer. I don't think pd1 has anything to do with giving you more white blood cells. It has to do with the pd1 medicine when it detects a white blood cell it attaches to it and dissolves the pd1 protein from the white blood cell. Then they call it an activated tcell that floats around and hopefully sees a cancer cell. When it does it attaches to it and destroys it then continues to the next cancer cell. One tcell can destroy up to 1000 cancer cells before it is depleted. So that could be a reason your white blood cells are low because they are destroying cancer cells. Also a reason to eat and drink healthy to keep those counts up. My white blood cells are typically high normal. I was above normal until the abraxane which dropped me back to high normal.

As far as tumor burden I think it's a combination of number of tumors and size and how you feel. Like one or two really big tumors or a bunch of small could be in my opinion high tumor burden. But the term really doesn't have any real use that I know of.

My doc up at Mayo is dr Kasi. He's a very caring doc. He's the only one that has called me on the phone and on several occasions. I really liked it there if I had to be at some medical place. But I'm going to md Anderson for now for consult and treated at home in Saint Louis.

Hope that helps.

Artie

Well I think anemic is when the hemoglobin is low. On pd1 mine slowly went down. Then they added abraxane and it had a larger drop. So they plan to give me blood if it drops again. But they said it had nothing to do with iron or anything with my diet. For me it was the abraxane although they never explained why my hemoglobin kept dropping slowly on pd1 just that my platelets were good so I was ok. Your doc should be able to explain what pd1 causes in blood work. They did for me but I don't remember all of it. When I say slowly it took over a year to drop into the red then with abraxane a larger drop in the red.

For white blood cells that is difficult to answer. I don't think pd1 has anything to do with giving you more white blood cells. It has to do with the pd1 medicine when it detects a white blood cell it attaches to it and dissolves the pd1 protein from the white blood cell. Then they call it an activated tcell that floats around and hopefully sees a cancer cell. When it does it attaches to it and destroys it then continues to the next cancer cell. One tcell can destroy up to 1000 cancer cells before it is depleted. So that could be a reason your white blood cells are low because they are destroying cancer cells. Also a reason to eat and drink healthy to keep those counts up. My white blood cells are typically high normal. I was above normal until the abraxane which dropped me back to high normal.

As far as tumor burden I think it's a combination of number of tumors and size and how you feel. Like one or two really big tumors or a bunch of small could be in my opinion high tumor burden. But the term really doesn't have any real use that I know of.

My doc up at Mayo is dr Kasi. He's a very caring doc. He's the only one that has called me on the phone and on several occasions. I really liked it there if I had to be at some medical place. But I'm going to md Anderson for now for consult and treated at home in Saint Louis.

Hope that helps.

Artie

Well I think anemic is when the hemoglobin is low. On pd1 mine slowly went down. Then they added abraxane and it had a larger drop. So they plan to give me blood if it drops again. But they said it had nothing to do with iron or anything with my diet. For me it was the abraxane although they never explained why my hemoglobin kept dropping slowly on pd1 just that my platelets were good so I was ok. Your doc should be able to explain what pd1 causes in blood work. They did for me but I don't remember all of it. When I say slowly it took over a year to drop into the red then with abraxane a larger drop in the red.

For white blood cells that is difficult to answer. I don't think pd1 has anything to do with giving you more white blood cells. It has to do with the pd1 medicine when it detects a white blood cell it attaches to it and dissolves the pd1 protein from the white blood cell. Then they call it an activated tcell that floats around and hopefully sees a cancer cell. When it does it attaches to it and destroys it then continues to the next cancer cell. One tcell can destroy up to 1000 cancer cells before it is depleted. So that could be a reason your white blood cells are low because they are destroying cancer cells. Also a reason to eat and drink healthy to keep those counts up. My white blood cells are typically high normal. I was above normal until the abraxane which dropped me back to high normal.

As far as tumor burden I think it's a combination of number of tumors and size and how you feel. Like one or two really big tumors or a bunch of small could be in my opinion high tumor burden. But the term really doesn't have any real use that I know of.

My doc up at Mayo is dr Kasi. He's a very caring doc. He's the only one that has called me on the phone and on several occasions. I really liked it there if I had to be at some medical place. But I'm going to md Anderson for now for consult and treated at home in Saint Louis.

Hope that helps.

Artie

Allyson, sorry to hear about your current situation.  Regarding tumor burden, I don't think there is a bright line rule.  You can have a dozen small tumors and be considered to have a low tumor burden, or just a few large ones and be considered to have a high burden.  Best wishes for success on Keytruda.  I did have a low white count for a few weeks while on Keytruda.  The doctors mentioned it as being odd but it eventually resolved.

Allyson, sorry to hear about your current situation.  Regarding tumor burden, I don't think there is a bright line rule.  You can have a dozen small tumors and be considered to have a low tumor burden, or just a few large ones and be considered to have a high burden.  Best wishes for success on Keytruda.  I did have a low white count for a few weeks while on Keytruda.  The doctors mentioned it as being odd but it eventually resolved.

Allyson, sorry to hear about your current situation.  Regarding tumor burden, I don't think there is a bright line rule.  You can have a dozen small tumors and be considered to have a low tumor burden, or just a few large ones and be considered to have a high burden.  Best wishes for success on Keytruda.  I did have a low white count for a few weeks while on Keytruda.  The doctors mentioned it as being odd but it eventually resolved.

Hi Allyson,

I started on Keytruda in July. I've had something like 6 or 7 infusions so far. My blood work has remained mostly normal, with the following exceptions:

My hemoglobin and hematocrit are both running a little low. They told me that compared to most of their patients, mine wasn't bad at all. But it was below the low end of the reference range.

My eosinophils have been high. I've read somewhere that they think that could be a marker that shows that I am responding to the Keytruda, so that one I'm happy about.

As for tumor burden, you pretty much nailed it. It's the number of tumors, size, location, etc. Mine, for example, is pretty low. Several spots on my skin, and in one lung. Everything in my lung is less than 1 cm.

I hope this info helps!

-Bill

Hi Allyson,

I started on Keytruda in July. I've had something like 6 or 7 infusions so far. My blood work has remained mostly normal, with the following exceptions:

My hemoglobin and hematocrit are both running a little low. They told me that compared to most of their patients, mine wasn't bad at all. But it was below the low end of the reference range.

My eosinophils have been high. I've read somewhere that they think that could be a marker that shows that I am responding to the Keytruda, so that one I'm happy about.

As for tumor burden, you pretty much nailed it. It's the number of tumors, size, location, etc. Mine, for example, is pretty low. Several spots on my skin, and in one lung. Everything in my lung is less than 1 cm.

I hope this info helps!

-Bill

Hi Allyson,

I started on Keytruda in July. I've had something like 6 or 7 infusions so far. My blood work has remained mostly normal, with the following exceptions:

My hemoglobin and hematocrit are both running a little low. They told me that compared to most of their patients, mine wasn't bad at all. But it was below the low end of the reference range.

My eosinophils have been high. I've read somewhere that they think that could be a marker that shows that I am responding to the Keytruda, so that one I'm happy about.

As for tumor burden, you pretty much nailed it. It's the number of tumors, size, location, etc. Mine, for example, is pretty low. Several spots on my skin, and in one lung. Everything in my lung is less than 1 cm.

I hope this info helps!

-Bill