Neulasta????

vlcarr · 12-08-2009, 09:00 PM

I've had my 3rd round of TCH and it seems most of the posts I've read indicate that everyone gets Neulasta when you did chemo. Is this true?

The reason I ask is that I've never had it. Isn't that a shot you get to boost your blood counts or something?

I mentioned this to my oncologist and she does not automatically give it after chemo. In fact, she does not like to give it at all unless she has to. I only have labs when I go for my chemo (every 3 weeks).

Just curious as to how many of you have or had this as a standard part of chemo. How would I know if I needed it?

Rich66 · 12-08-2009, 09:25 PM

My understanding is that if they didn't give it preemptively, and your white blood keep up enough to stay on schedule, probably not going to get it. Although..I think Becky had a different blood support called Leukine (GM-CSF) at her request in order to gain additional immune benefit. In any case, I suspect it's good news your immune system is robust enough to stay on schedule without it.

sassy · 12-08-2009, 09:33 PM

Most who receive Neulasta are those on dose-dense chemo which is administered every two weeks as opposed to every three weeks. A two week interval does not allow as much time for your white counts to rebound.

Your blood work is taken prior to each chemo to determine what your counts are and would indicate if your white count was too low to have chemo administered.

Chelee · 12-08-2009, 11:03 PM

Hi Vicky, I did TCH and my counts started dropping the 2nd wk after my 1st infusion. They usually have your labs ran the morning of your infusion to make sure your WBC (white blood count) is in a safe range. If they see it's too low they will have you come in the day after your infusion for a neulasta injection. Some people don't need them...their counts bounce back quicker then others.

But do pay attention...ask your chemo nurse or onc for a copy of your labs. When I had my first go around I didn't know a thing about my counts or neulasta and it cost me big time!!! My onc had told me my counts were getting low but on wk 3 after my first infusion he FORGOT to tell my WBC was in the toilet. I ended up really sick and landed in the hospital for 12 days on oxygen, wide specturm of anti-biotics & heart moniter. (That cost me a total of 21 days down time I had to be off chemo.) You don't want to end up with neutropenia. Hopefully your onc is paying attention to WBC and would let you know if yours dropped. You just may be one that doesn't need it. But to be on the safe side...ask for copies of yours labs and check yourself.

Chelee

Rich66 · 12-09-2009, 12:15 AM

Chelee's post got me thinking. If there is a cumulative wbc lowering effect, might not be crazy to ask for more frequent labs. Some facilities do weekly. And Chelee's right. Neutropenic fever can be a major event. I was traveling with my mom after her 1 round of Taxol for a second opinion when hers hit in a hotel. In hindsight, there were warning signs but despite being seen in an ER the same day for severe mucostius with nadir/low wbc mentioned, we weren't told what to watch out for. So...if you feel a lot of chills and you just can't get warm, you might soon be on your way to the opposite, severe fever. I was naively giving mom extra blankets. Then a few hours later she woke up in a manic/feverish state repeating words senselessly and had to be taken by ambulance for a week long hospital stay with every antibiotic they could hang on the IV tree. They said a little more delay and she might have passed. I was freaked out by the whole scenario. I can't believe we weren't forewarned. Passing it along.

Ellie F · 12-09-2009, 04:25 AM

Hi
I had severe neutropenia after my first dose of AC and was hospitalised and told I could have died. However my onc refused to give it me for the remaining 3 doses but I was fine. This year I insisted on it before having taxotere, my new onc gives it to all his chemo patients.
Ellie

DonnaD · 12-09-2009, 07:15 AM

Dose dense chemo does get Neulasta for the reason Sassy stated. My chemo was every three weeks. My onc does not give it for the 3 week chemo schedule unless needed. I did fine the first two treatments and then my white blood cell counts dropped delaying treatment for a few days. After that I had Neulasta each time.

Your labs are done before each treatment. You can get a copy of them just ask your onc or the nurse giving you your treatment. They can explain what the numbers should be.

Sounds like you are doing fine. Good for you!
Donna

vlcarr · 12-09-2009, 09:03 AM

I've had a fever with each of my chemo treatments during Nadir It did go over 100.5 once and my instructions are to go to the ER if the doctor's office is closed.

I can access my lab reports on line. There is also a feature that explains what the test is for and what the normal range is. I'll have to go back and look at those again. I did go in after my 2nd treatment because my fever was 100.5 and they gave me antibiotics by IV.

Rich, I remember having chills and that is what prompted me to check my temp. The onc said if I don't remember anything else she told me to remember the 100.5 fever and address it immediately.

Thank you for the information on neulasta.