@sheridan2026 Your story of your relationship with your oncologist is so disheartening. It’s difficult to have a level of confidence in your treatment when you feel your doctor is being dismissive. Comparing your current treatment for AML with your prior and very positive, out-of-state provider is showing two very different approaches. I’m sorry you’re having to go through this! No wonder you’d like to change doctors. Your current doctor sounds a bit prickly and not very willing to work with you to gain your trust.

If I may though, from my own experience with AML, blood numbers can drop considerable through each cycle, taking longer to rebound with subsequent cycles. Pegfilgrastim (Neulasta) is given once per month immediately following a chemo cycle. It’s longer lasting than the Neupogen which can be given daily. Doctors often opt Neulasta for a prolonged effect of increasing the neutorphils.

In the past though, you have had a better experience in your treatment with daily Neupogen injections. It would be nice if your current doctor would at least explain to you the reasoning behind opting for Neulasta over Neupogen. I see your next appointment is with his NP. Nurse practitioners are an integral part of our oncology teams and usually have more time available to answer questions. So you might want to chat with the NP about weighing these meds against the other. I know, it shouldn’t have to be this way…like pulling teeth to get good medical care. You’d like to be heard on your own merit! But it wouldn’t hurt to have a notebook with your questions to ask.

Regarding platelets, I don’t know if you’ll find this helpful or not but the American Society of Clinical Oncology (ASCO) guidelines emphasize careful patient selection to avoid unnecessary transfusions, ensuring that only those most likely to benefit receive them. Platelet transfusions are indicated for patients with a platelet count below 10,000/μL or those with higher counts experiencing active bleeding.

Your doctor is following the guidelines for patient platelet transfusions. Again, from my own AML experience, I only received platelets if my level was nearing 10,000, usually mid-cycle.

As we age our bodies have a more difficult time processing the medications. Fortunately the newer treatments for AML are of a lesser intensity and better tolerated by the body. But each round can still take a little more time to recover from.
I see you recently started Inqovi along with Venectoclax. This is one of the newer protocol that has been quite successful in reducing blast counts and bringing patients to remission. Years ago, this was not possible! So I hope you can strike a good accord with your doctor. At least from my perspective, you are getting up to date medical care with your doctor following current protocol.

What was your latest blast count? How’s your hemoglobin level?