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Taken prednisone for ITP. Not responding. On Rubatuxan. Going for radiation for prostrate cancer. Are my platelet levels safe?

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Practicing since : 2002
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last year I had ITP count down to 11,000. took predisione did not work . Took four chemo of rubatuxan ( probably spelled wrong) any way platelets went up every week till 135,000 .then took blood count every one to two months and stayed above 100,000 then last week took blood test because I am going to have external radiation for early stage Prostate Cancer and count was down to 54,000 What s up ? blood count stayed up about 6 mo.
Posted Mon, 21 May 2012 in Blood Disorders
Answered by Dr. Robert Galamaga 6 hours later
Hello and thank you for submitting your question.

Your question is a good one and I will work on providing you with some information and recommendations.

ITP does not always follow a particular pattern regarding response to medication including prednisone and rituxan. This can sometimes persist for many months or even years. I want to reassure you that right now you are not at risk for any amount of significant bleeding. As long as you're platelet count remains above 50,000 you should not have any problem.

There are several other medications which can be considered if you're platelet count continues to fall. This includes some immunosuppressant therapy as well as some new medications which have been developed to help stimulate the platelet count.

A new medication called Promacta can significantly improve the platelet count in patients with your condition. I would encourage you to talk about this with your hematologist to see if you might qualify to use this medication. In very rare occasions patients with your condition may need to have their spleen removed.

Again I do not think you are at risk for any spontaneous bleeding at this point. I would recommend that your platelet count is monitored through the course of your radiation therapy. I do not see any problem with proceeding with radiation as long as you're platelet count continues to be above 50,000.

Again I thank you for submitting your question. I hope you have found my response to be helpful and informative. If you have any additional concerns I would be happy to address them.


Dr. Robert
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