What blood tests should be done while being treated with Ocrevus?

Here is My Question:
I currently am on Ocrelizumab. My doctor does no blood work other than CBC and LFT before each dose. They did check for hep b before the first half doses. Are there additional blood tests that should be done while being treated with OCREVUS? 

Answer:
You doctor is doing the minimal amount of blood testing required for people who are already receiving Ocrevus. Many MS specialists do additional testing for the following reasons:

1. Many doctors monitor immunoglobulin levels (IgG, IgM, IgA) before starting treatment and then every 6 to 12 months. A significant number of people on Ocrevus will become deficient in IgM and IgG antibodies with prolonged treatment and this may increase the risk of certain infections, particularly upper respiratory tract infections. These deficiencies can be corrected with immunoglobulin infusions if necessary.

2. Most doctors recommend regular cancer screenings, particular breast and cervical for women and skin for all

3. Some doctors track CD19 blood counts to adjust the interval between infusions, generally lengthening the interval between treatments to hopefully minimize the potential risks of long term treatment. The current recommended treatment interval is every 6 months, but there is some evidence that this interval can be extended if B cell counts (CD19 + cells) remain suppressed 6 months after infusions. This requires considerably more study, before this practice can recommended.

Revere (Rip) Kinkel MD
Professor of Clinical Neurosciences
Director of the Multiple Sclerosis Program
Clinical Neurosciences Director
University of California San Diego