@garyr443 Yes, HU can reduce all blood cell counts. The trick is to find the HU dose that addresses platelet over production but doesn't tank everything else.

Remember that blood counts do fluctuate normally. So it's important to look at whether yr red cell number is not just reduced but below normal.

If you are dipping into below- or above-normal levels with anything, that would be something to discuss with your doc or hemo nurse.

In my experience (18 years w ET, 8 on HU), even if a number dips a bit below normal, they'll wait another 3-6 months to see if it recovers on its own.

Also, my hospital system has narrowed the normal range for several blood counts. So my other blood cells may not have taken dropped much, but suddenly they're classified as low.