Understanding Your Blood Counts

Mesothelioma patients who are undergoing chemotherapy will have frequent blood tests to help monitor for any side effects that could be potentially harmful or cause delays in scheduled treatments. The CBC, or complete blood count, measures the cells in your blood in relation to normal ranges. Your doctor will use these ranges as a reference point, however, it will be up to him or her to determine when and how a specific problem needs to be addressed.

A complete blood count measures the amounts of three different types of cells in your blood:

• Red blood cells make up the largest component of the blood, and transport oxygen from the lungs throughout the rest of the body. They help provide energy and keep organs and tissues healthy. Hemoglobin is the protein contained in red blood cells that makes blood red. Hematocrit is the percentage of red cells in the bloodstream. If your hemoglobin or hematocrit level is too low, it is possible that you have anemia, which may cause you to feel tired or weak. Other symptoms may include shortness of breath, increased heart rate, difficulty staying warm, pale skin and dizziness or lightheadedness.
• White blood cells provide protection for the body against invasion from bacteria and viruses, and therefore, play a key role in the body's immune system. Neutrophils, are a specific type of white blood cell. If your absolute neutrophil count (ANC) falls below normal range, you may have neutropenia, or a low white cell count, which can lower the body's ability to fight infection.
• Platelets help the blood clot. They line the inside of the blood vessels and flow through the vessels as well. If you have low platelet counts, you may be at increased risk for bleeding or bruising.

The goal of chemotherapy is to kill cancer cells which divide rapidly, however, cells in the bone marrow that produce red and white blood cells and platelets also divide rapidly. If these cells are damaged, low blood counts can result. Low blood counts may be treated by the administration of blood cell growth factors which stimulate the cells in the bone marrow to produce more red cells, white cells or platelets. These growth factors, while produced by the body, have also been produced in the laboratory, and are approved by the Food and Drug Administration for use in cancer patients with low blood counts. Following are the brand names of the drugs normally prescribed:

• For low red blood cell counts: Epogen7 (epoetin alfa), Procrit7 (epoetin alfa), Aransep7 (darbepoetin alfa).
• For low white blood cell counts (neutropenia): Neupogen7 (filgrastim), Neulasta7 (pegfilgrastim).
• For low platelet counts: Neumega7.

Commercially available blood cell growth factors are available only by prescription. Your doctor will determine which drug may be appropriate in your case, and will explain the benefits and potential risks. In the case of severe low blood counts, blood transfusions may be necessary. If you have been diagnosed with mesothelioma and are undergoing chemotherapy, you should be aware of the symptoms associated with low blood counts and should report them to your doctor immediately. By being proactive in this respect, you can help prevent delays in treatment that may cause your chemotherapy to be less effective than it might otherwise be.