Hello Ladies,
I was wondering if anyone else has had a similar experience to me on the palbociclib/letrozole regime. Since starting the drug in Jan 2022 my haemoglobin levels have been dropping. The latest result is 89. Also my platelet count has dropped to 94. My dose was reduced from 125 to 100mg last month due to low neutrophils (two months in a row with low neutrophils). I’ve just received the latest blood results after one cycle on the reduced dose and to my dismay the neutrophils are 0.6 and I will have to delay treatment again by a week. Do you think it just takes the body a while to adjust to the new dose or will I have to reduce the dose again? I’m really concerned that, although the drug combo is proving effective in treating the cancer, my bloods are struggling.
I was low for the first few sessions and then they lowered the dose, which I was really concerned about but the doctor said it’s better to be regular with the treatment than have the higher dose. My first one with the lower dose was still low and delayed but then after that I’ve been ok and at 1.1 ish for my neutrophils. My oncologist said that the first month with the lower dose the body is still adjusting, so hopefully your next one will be fine like mine has been. I also found that when I adjusted to the lower dose I’ve been a lot less tired so will keep everything crossed for you x
I am new hear and finished by first cycle of Palbociclib last week Tuesday, but after the first 2 weeks blood test my WBC was 0.89, so had to have another blood test a week later which had dropped again to 0.5 but was the start of my weeks break.
I had my bloods Monday and had a call today to say that they had dropped again and to have an extra weeks break and an extra blood test next week to see if they are back up and then they said they may reduce the dose from 125 to 100 i assume.
As this is my first cycle and now my second is being delayed I am worried that this is not going to be a smooth ride, my diagnosis went from being positive to cure to then being confirmed as secondary BC spread to my Liver so feeling a bit unsure how this is going to pan out.
Hi , I was diagnosed straight to secondary Feb 2024 bones and bowel , started ribociclib March 2024 my neutrophils low after first cycle , they reduced dose , still Affected my neutrophils only managed 4 cycles in total then it affected my liver function so had a few months break . However started abemaciclib middle dose Nov 2024 my bloods have been perfect and I have had stable scans . I’m sure if this continues they will change you to alternative .
I attend Maggies group for secondary breast cancer and it appears this is not uncommon having to switch drugs due to low neutrophils . Hope this reassures you xx
Thank you for your reply, are you on hormone treatment too I am on Letrozole too ?
How did you feel when your WBC were low and how low did they go, I don’t feel unwell just a little more tired than usual but I think that is to do with the time of year.
What area of the country are you as wondering why they prescribed you Ribociclib for first line of treatment and not Palbociclib ?
I don’t have a Maggies near me but I am going to a monthly group meeting arranged by Breast Cancer for Now, so will hopefully get some more support and answers there.
So you have been on your medication for nearly 2 years now, how are you feeling in your self and are you still managing to work and live life well.
Hi , I’m from The northeast . I also take letrezole , denosumab for my bones and zoladex to put me through the menopause as I was diagnosed at 49.
While on the ribociclib I was exhausted most days , fatigued , also joint stiffness of the remaining drugs and going into the menopause over night came With additional Side effects to .
Since starting the abemaciclib I feel much better but I have days in the week where I just rest , if I am Planning to do something the next day . I can’t function alL day , everyday like I did prior to diagnosis and starting medications .
I am retired now .
At maggies the group many ladies are on various medications but the target therapies , mainly prescribed palbociclib and Ribociclib x
I am currently on Palbociclib since May 2025, I started on 100mg, by October I was reduced to 75mg due to low WBCs, I still have low WBCs every month on the lowest dose, always dropping to .6, so I have two weeks off in total before I go back on the tablet, after the 14 days my WBC are usually just back above 1.
I have had three stable scans since I started this regime, so it seems to be doing its job even with the extra week off the tablet. I had been on Ribociclib first for two months, my liver couldn’t process it, so I am keen to stay on the Palbociclib as long as I can, before I am moved to the third option.
I find by day 17 on Palbociclib I am looking forward to having the break from it, as I always feel like fatigue is starting, ironically the first seven days I am off the tablet is when my system feels the lowest! I avoid crowds etc. when I know my WBCs are low, I haven’t had anything like a head cold etc since I started Targeted Therapy, so I find avoiding situations where bugs would be typical helps.
I hope this information helps you, last year I thought the extra seven days off the tablet would have an effect on my tumours, so far not, I’m still hopeful I might settle on it at some stage, even after 10 months so I hope your WBC settle soon! No two people are the same, but always good to read other people’s experiences.
Thank you for your reply it is appreciated to know as you are still early on on your treatment regime too, glad it is going well.
The second cycle on the lower dose 100mg went well at the 2 week check and no change from 1.1, but on the 7 day break it went to 0.8 so was given another 7 days break.
Thought they were going to lower the dose again but as they went back up to 1.3 they said to continue 3rd cycle on 100 and no check on bloods until 4 weeks, which coincides with my 3 month check up with the Dr following my scan 13/4/26.
I am getting nervous as I am getting mild pain in the liver area where my mets are and sometimes in other areas, but it is worse when not taking palbo as it calms down when back on treatment?
Where are your mets and how did they diagnose your liver was not processing the treatment was it through bloods.
Great you can stay on your dose of 100mg until the next bloods. Hopefully your scan is stable and you continue on as you are, as time goes on you realise it’s not a bad place to be, (not that I did last year) it’s now I realise you adjust life to living around this treatment.
My tumours are on my lungs and sternum. I was breathless for 2 months until the treatment started working, along with radiation.
When I was on Ribociclib bloods showed my ALTs going from a normal range of something like 35 to 900, so it took 10 weeks for my liver range to return to normal, so I had no tablet for the 10 weeks, just the fulvestrant and xgeva injections, so I was worried my cancer would continue spreading in the 10 weeks, it didn’t, so I realised then how important the fulvestrant injections were working solo!
I’m 10 months on the Palbociclib and still not settled so for some people it’s a slower settling period, but things are still working in the background thankfully
so I hope your WBC settle soon! No two people are the same, but always good to read other people’s experiences.