Neulasta not working

Anyone have issues with Neulasta not helping their white cell count?  My wife had her first treatment on on 03/20 and when she had her counts taken on 03/25, they were almost non-existent.  She has stage III ILC and is scheduled to have 8 rnds of chemo over 16 weeks.  So, this is not how we were hoping things would start out.  Otherwise, she felt fine.  No real negative side effects from either the chemo or the neulasta. 

Comments

  • Anonymous
    Anonymous Member Posts: 1,376
    edited March 2009

    Hi...I cannot answer your question - but I'm sure someone here will. I personally did not have any wbc probs... I was fortunate that the Neulasta worked...(although the bone pain was horrible). But that doesn't happen to everyone. It's great that she feels so good!

    Since she was dx'd same as me - ILC - I'm curious what chemo she's getting. Mine was three years ago - AC 4x dose dense and Taxol 4x dose dense. The reason I'm curious is because I heard that some Oncs have recently started using a different combo for ILC patients. (I hope you don't mind me asking.)  

    I just found a patient info line/site for Neulasta patients...perhaps they will be able to help you two... (bias, no doubt, but they may have a good answer/solution, afterall, they WANT their product to be effective):

    http://www.neulasta.com/patient/support_network/index.jsp 

  • ladyjane54
    ladyjane54 Member Posts: 192
    edited April 2009

    I had problems the Neulasta shot not working.  I had four rounds of A/C and ended up in the hospital on treatments 2 and 4 due to running a fever and having no WBCs mine hit zero both times.  Make sure you call the doctor right away if your wife starts to run a fever.  Also it is important do make sure she knows what her nadir day is so she can be extra careful about being exposed to anything when her WBC is down.

    Good luck to both of you.

    Patti

  • miande
    miande Member Posts: 2
    edited April 2009

    Laura, she is receiving the same chemo as you.  Her dx is 8cm, IIIb, Grade 2, ER+/PR+, HER2-.   Two nodes appeared irregular under MRI and needle biopsy confirmed positive for both.  She will not have surgery until after chemo is over and I geuss we will learn about other nodal involvement after that.  Thanks for the link.  I will check it out. 

    Patti, what is nadir?  Is there one day when your wbc count is lower? 

    Mike

  • Hood1980
    Hood1980 Member Posts: 537
    edited April 2009

    Mike,  I'm not the expert on neulasta but I did take a Hematology class in college... What I understand is that Neulasta works on boosting neutrophils, only one type of white blood cells (wbc).  There are several types of wbc so perhaps those other categories are low???  Just a thought, not meant to convey expertise.  Hopefully someone else will be along and can offer that.  Best of luck to you & your wife.  I think that it's wonderful that you are out doing research for her.

  • ladyjane54
    ladyjane54 Member Posts: 192
    edited April 2009

    MIke:  Your nadir day is the day on which they expect your white blood cells to be their lowest.  Depending on what type of chemo she is getting it is usually anywhere from 7 to 10 days after treatment.  Her doctor should be able to tell you when it is.  Patti

  • Anonymous
    Anonymous Member Posts: 1,376
    edited April 2009

    Mike - Thanks for the response. Fingers crossed that the neo-adjuvant chemo will shrink her tumor A LOT! I have read here at this site, many times, that considerable shrinkage occurred. I am also hoping there's no more node involvement.

    Have you visited the ILC FORUM here? If not, please feel free to pop in. If you would like ongoing support through your wife's treatment, you could start a thread there and we would help you through it all...just FYI.

    Best wishes...if you're up to it, keep us posted.

  • Tamara67646
    Tamara67646 Member Posts: 293
    edited April 2009

    Mike,

    I had a similiar situation after my first tx, even with the Neulasta shot, my wbc count was .7.  So I was then given 3 days of Neupogen shots.  The pattern we stuck to over the next 5 tx was chemo on Friday, Neulasta on Monday, Nepogen on Wed, Thurs, Fri.  That keep my count in a reasonable range.  I know most get the Neulasta the day after chemo and I will always think that part of the issue was that my onco's office was available to do the shots on Saturday and I had the delayed time frame but my onco insisted that wouldn't make a difference.  He explained that Neulasta takes longer to raise you wbc but lasts longer than Nepogen (hence why you usually only need one Neulasta but mulitple neopogen shots) and my nadir was dropping faster than typical and the Neulasta didn't have time to react.

    Good luck to your wife on the rest of her tx.

    Tamara

  • chiquita
    chiquita Member Posts: 135
    edited April 2009

    Mike, I have nupogen 7 days after the chemo and 7 shots one every day my husband does the injections and work fast my wbc goes up and stay up until the end of 3 weeks of chemo...ask your Dr. for it instead neulasta. Good luck.

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