I am a patent who has chronic hepatitis C and undergoing interferon and
ribavirin thereapy. Nuetropenia (ANC 888-1063) onset at 9th week of Tx
(usually if due to Tx, is early onset) and onset of lymphocytosis and
monocytosis (not present during HCV infection prior to Tx- though found
old lab from 2000 with large monocyte count, resloved thereafter and
globulin/Albumin ratio due to elevated globulin) In 18th week of Tx rise
AST to slightly above normal, (which had normalized after 1 month of Tx),
recent rise in Alkaline Phosphatase w/ normal GGT. WBC is 2.3 and
No signs of infection. CT of abdomen and pelvis revealed bilateral
para-arotic and iliac nodes, cysts in ovaries and WNL fluid in abdomen,
auxillary spleen and no abcess. HCV is linked to diffuse large B-cell
lymphoma. What would you do with the patient next? Marrow biopsy? Node
biopsy? Could all of this be due to marrow suppression from Tx?
Please, any feedback at all would be highly appreciated!