Platlets are too low to transplant safely - Dr recommends N Plate. Heard of it?

[laphoenix]

My platelet count is too low to proceed with transplantation. They  "discovered" this after being on the waiting list for almost 8 years. Saw the hematologist today and he recommended N Plate to increase the platelet count. Sounded promising at the office visit but now that I've had a chance to Google it, not so much....some scary side effects not only upon usage but also when it's discontinued. So if has anyone has had this drug could you tell me about your experience with it? Thanks

[Simon Dog]

I had low platelets when i was scheduled for a hip replacement.  The platelets were hovering aound 30, and the surgeon wouldn't operate without a count of at least 100.

First, the hemo guy tried IVGG infusions - no luck.  He then tried Nplate.   I went to the hospital, had a platelet count done, the MD would then prescribe the dose, and I would get a subq injection of about 0.2CC Nplate.  The insurance negotiated price was about $1450 per injection.     It worked, my platelets shot up, and I had a successful hip replacement.   Since then, my platelets have bounced back to about 125 without nplate, and the hematologist assures me the nplate has long since left my system and is not the reason for my higher count at this time.

I didn't have anything bad happen from the Nplate.

[laphoenix]

Thank you Simon Dog for your knowledgeable input... yes they won't operate without a count of at least 100 and the price is about what they told me. Although one is hardly a good sample size, it is good to hear you didn't have any adverse reaction. Sometimes I think I shouldn't read warning labels If I may ask how many injections did you receive before your surgery? Thanks for taking the time to respond....

[Simon Dog]

I don't remember exactly, but it was weekly for about 3 weeks +/-1.    The hematologist worked with the ortho surgeon so he would be ready to pounce on me as soon as my platelets got to a good level, and I was done on Halloween on 2014, so I was trick or treating for oxycodone and colace.   My other other issue was low HGB, and my nephrologist did a great job of managing my epo to get me up above 11 which was the minimum the hospital required for me to open an account at the blood bank.   I was in for 6 days instead of the expected 2, since my HGB was in the 6.2 range, and I was (with the help and backing of a wonderful hemotologist) refusing transfusions.

I had seen the hematologist for the thrombocytopenia, and he became my guardian angle while I was in for the hip.  He wasn't even a MD of record on my case (he never billed for any of the consults during my surgical stay), but was seeing me daily and conferring with the other MDs, particularly the residents and fellows who kept trying to order a transfusion (after the one unit I deposited was used up), explaining why my request to avoid allogenic blood was reasonable.   It's amazing how some MDs outside the transplant world are oblivious to the issue.

Loads of drugs have rare, but serious, side effects.   Prednisone is an extremely common Rx, but it did the number on my hip necessitating replacement.

[laphoenix]

Thank you Simon Dog!

Would still like to hear from any others who've had experience with N Plate.....

[Simon Dog]

If you are going to worry about side effects, you would never consider a transplant 

It's all a risk/reward balancing act.