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Low Platelets with Myelodysplastic Syndrome (MDS)

Blood Cancers & Disorders | Last Active: Jan 24, 2023 | Replies (39)
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@shels93

Hi Lori,
I'm back with questions...I just got home a little bit ago; my husband was told to go to the ER today because he woke up with a headache and had a fever of 100.8 (they told him to call if it went above 100.4). We were in the ER for 7 hours. His temp registered at 103.4 (forehead scan) then 102.7 (under the tongue) at 2:25PM (we got there around 1:00PM), then he registered 102 (forehead scan) and 102.9 (under the tongue) at 6:28PM. He had two transfusions this week, both blood and platelets. They had him go to the ER on Tuesday night after getting his non-treatment week bloodwork done. His WBC's were 3.42, RBC's were 1.84, Platelets were 13, Hemoglobin was 6.4. Last treatment was Nov. 22 (Vidaza); the above test was done on Nov. 29. He ended up get one transfusion then, and another one on Dec. 1.; WBC=3.17, RBC=2.13, Platelets=14, Hemoglobin=7.5. Today in ER the only lab I can currently know is Neutrophils at 1.38 (others haven't been posted yet). They don't know what is going on and admitted him. They did a chest x-ray and also cat scan of his head; I have not received that info yet either. Tested negative for Covid and RSV. Does any of this sound normal given his MDS and Vidaza treatment? He had taken Tylenol at 8AM but that didn't help the headache, and they gave him more Tylenol at the hospital (he's on meds for chronic AFIB and high blood pressure. Thanks in advance for any info you can provide.

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Replies to "Hi Lori, I'm back with questions...I just got home a little bit ago; my husband was..."
Lori, Volunteer Mentor | @loribmt | Dec 4, 2022

Hi @shels93, I know the anxiety of an unexplained fever when on chemotherapy. It isn’t uncommon for that to happen several days after the last chemo treatment.

For your husband this is occurring during his off-treatment week and his blood numbers, before the transfusions, were quite low. That is when there is a possibility of a neutropenic fever. There often is no discernible cause but all precautions such as getting him back to the hospital for observation and possibly antibiotics is important. So he’s in the right place.

It looks like the transfusions helped elevate his red blood count and his platelets. But the WBC will have to regenerate on its own. Fairly frequently after Chemo, patients are given a medication to help promote WBC generation such as Neulasta. It can help prevent the possibly of infections due to the low WBC. Do you know if he was given Neulasta?

I’m expecting with some of the blood work his doctors ordered today that they also did a blood culture to check for bacterial infections. Those results can take a few days to return. He may also receive some prophylactic antibiotics if his fever persists.

Wish I had better news for you but this is not uncommon to have an unexplained fever and needing transfusions of RBC and platelets.He should start feeling better as his WBC count starts increasing again. How has he been doing otherwise? Are his doctors encouraged with his treatments?

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