Likely nadir period for blood counts after two doses of Cisplatin?

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Hi everyone,

I’m currently  being treated for endometrial cancer.

I have just finished two doses of Cisplatin (50 mg/m²) alongside 5 weeks of pelvic radiation as adjuvant treatment after a laparoscopic vaginal hysterectomy (no lymph nodes removed).

I’m trying to get a clearer idea of how my blood counts might behave over the next few weeks during a break  before I start the final phase of my treatment.

Specifically:

When do neutrophils and platelets typically hit their nadir (lowest point) with this regimen?

Is there a usual delay before the drop shows up (e.g., 7–10 days)?

How long does the nadir typically last, and when does recovery begin—specifically  given I have had two doses which were three weeks apart, and I am now moving on from the second one into a 4 week period with a break from both chemo and radiotherapy?

I’m not currently on G-CSF or Neulasta, and I’m doing a lot to stay well-hydrated and nourished, especially during peak cytotoxic windows.

If anyone has experience tracking their own blood counts on this protocol, or knows of clinical resources or charts showing the typical timing, I’d really appreciate your insights.

Thanks so much in advance and warm wishes to everyone going through this. Yellow heart

(Woman in mid-life, based in Australia, overall good health pre-treatment.)

  • Hello asea aranion,

    Thank you for getting in touch with us, and welcome to our online community. My name is Annerose I’m one of the Cancer Information Nurses here at the Macmillan Cancer Support line.

    I hope you are coping well with your treatment, and it’s great to hear that you keep yourself well hydrated and keeping to a healthy and balanced diet.

    It is understandable to be concerned about the recovery from the myelosuppression that Cisplatin in combination with Radiotherapy can cause.

    Risk of infection is a common side effect of this treatment, and can occur in up to 1 in 10 people receiving Cisplatin.

    The nadir, the lowest point in circulating blood-cells, is dose related, and can be different for every individual person. As a general rule, the lowest point ranges from 7 to 45 days after a single dose, and most patients recover within 39 days, with a range from 13 to 62 days.

    I understand this is a big gap, but I cannot narrow it down for you. However, you should be able to get your blood results from and discuss the recovery of your Immune system with your health care team, or your GP.

    Alternatively, as you are based in Australia, they have a similar system to the UK where you can access your health record, via secure online platform for managing your health information. You would need to register, and then you can view and manage your health information, including blood results within the My Heath Record.

    I hope this has been helpful, but please don’t hesitate to get back in touch if you need any further information or support.

    Best wishes and take care 

    Annerose (Cancer Information Nurse Specialist) 

    You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email. 

    Ref/ AM/KR