Transplant: Regarding Cellcept dosage, is there a test?

Posted by hello1234 @hello1234, Jul 10, 2021

Hi Transplant Family! I just celebrated my one year post kidney transplant anniversary! My only challenge has been neutropenia, leukopenia (supported with Neupogen shots when Neutrophil Absolute fell under 1.0), mild elevated liver enzymes and most recently invasive CMV infection. I would like to avoid over-immune suppression moving forward without triggering rejection. I know they use the tacronlimis blood level test to control the Envarsus XR level, but what indicators and factors are used to determine the correct Cellcept dosage? Thank you to my new Mayo Connect family, this is my first post. Signed, Truly Blessed!

Interested in more discussions like this? Go to the Transplants group.

Hello @hello1234 and welcome to the Mayo Clinic Connect community! Congratulations on your one year anniversary; that is wonderful news! Regarding your question about Cellcept specifically, and how the correct dosage is determined, I found this article that you may find helpful. It looks like blood tests to measure your blood cell counts are what is relied upon to adjust the dose.

From the article:
"Your doctor will do blood tests before you start taking CellCept and during treatment with CellCept to check your blood cell counts."

– Cellcept Drug:
https://www.rxlist.com/cellcept-drug.htm
When is the last time you have had a blood test run to check your blood cell counts?

REPLY
@amandajro

Hello @hello1234 and welcome to the Mayo Clinic Connect community! Congratulations on your one year anniversary; that is wonderful news! Regarding your question about Cellcept specifically, and how the correct dosage is determined, I found this article that you may find helpful. It looks like blood tests to measure your blood cell counts are what is relied upon to adjust the dose.

From the article:
"Your doctor will do blood tests before you start taking CellCept and during treatment with CellCept to check your blood cell counts."

– Cellcept Drug:
https://www.rxlist.com/cellcept-drug.htm
When is the last time you have had a blood test run to check your blood cell counts?

Jump to this post

Wow! Thank you for sharing this. I am bringing the topic of Mycophenolate to my liver doctor next week as I have had a sore throat for two months now and got an infection in a bug bite last week, for which I was placed on antibiotics. So, I’ll see if I can get tested like they do for Tacrolimus.

REPLY
@amandajro

Hello @hello1234 and welcome to the Mayo Clinic Connect community! Congratulations on your one year anniversary; that is wonderful news! Regarding your question about Cellcept specifically, and how the correct dosage is determined, I found this article that you may find helpful. It looks like blood tests to measure your blood cell counts are what is relied upon to adjust the dose.

From the article:
"Your doctor will do blood tests before you start taking CellCept and during treatment with CellCept to check your blood cell counts."

– Cellcept Drug:
https://www.rxlist.com/cellcept-drug.htm
When is the last time you have had a blood test run to check your blood cell counts?

Jump to this post

Thank you so much for this article on Cellcept Amanda! In the last year, I have consistently had a low WBC, a low Neutrophil Absolute number, and a low Lymphocyte number. I thought that was the goal for immune suppression. Is it possible to have normal levels of WBC, lymphocytes and neutrophils and still be protected from rejection? Can kidney transplant patients have normal WBC numbers, neutrophils and lymphocytes and still be protected against rejection? Thank you again for helping me!

REPLY

I am learning so much from this discussion about things that I never thought about!

I looked up my records on my patient portal. I see that I have a lab result listed for Mycophenolic acid as part of my annual evaluation for my transplant. Lab values include Mycophenolic Acid and MPA Glucuronide. I don't know what the results mean and I have not inquired. My PA will go over my lab results with me, and I listen for her to say that my Mycophenolate level looks good.

My tacrolimus level is tested each time I have my routine scheduled labs drawn for my transplant. It is a mail-in kit that Mayo processes.

Our lab results are looked at as a whole by our transplant specialists. And are interpreted according to our unique organ and underlying conditions. My numbers are not your numbers, and some of my numbers which look high or low to me, are acceptable according to my team. Even my PCP, relies on the voice of my transplant doctors.

REPLY
@rosemarya

I am learning so much from this discussion about things that I never thought about!

I looked up my records on my patient portal. I see that I have a lab result listed for Mycophenolic acid as part of my annual evaluation for my transplant. Lab values include Mycophenolic Acid and MPA Glucuronide. I don't know what the results mean and I have not inquired. My PA will go over my lab results with me, and I listen for her to say that my Mycophenolate level looks good.

My tacrolimus level is tested each time I have my routine scheduled labs drawn for my transplant. It is a mail-in kit that Mayo processes.

Our lab results are looked at as a whole by our transplant specialists. And are interpreted according to our unique organ and underlying conditions. My numbers are not your numbers, and some of my numbers which look high or low to me, are acceptable according to my team. Even my PCP, relies on the voice of my transplant doctors.

Jump to this post

Hi Rosemary! Thank you so much for telling me about the Mycophenole Acid test and MPA lab tests! I am going to ask about them to see if they may be helpful to me for determining my optimum Cellcept dosage moving forward. Are your WBC, Neutrophil Abs, and Lymphocyte tests in the normal range?

REPLY
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