neutropenia

nursewithbreastca

  I am due for my second chemo treatment of adriamycin &cytoxan Aug 10th. My neutrophils were 740 as of Aug 2nd. I did receive neulasta 24 hrs after my first treatment.  My Oncologist said they won't treat below 1500, but I don't feel comfortable being treated at less than 2500. How fast does the neulasta work?  Should I chose to delay the treatment until my neutrophils come up? I have no signs of infection so far. Any comments of suggestions would be helpful to me. Thanks

Claire_in_Seattle

Dear Nurse,

Amgen recommends three weeks between infusions for all your blood counts to come back, but mine always came up just fine on the DD protocol I was on (every 2 weeks).  I am assuming they will do blood work immediately before your next infusion.  This is when they will know if OK to move forward.

I started in the normal range, and then the Neulasta actually raised them to above my baseline, so this may happen with you.  As I said, you won't know until your blood work.

So make sure they do a CBC just before you are due for your next infusion, and then make the decision.  I am guessing they will be just fine.  BTW - I never had any problems at all with infection.  Good luck. - Claire

Isla

I am on AC every 3 weeks.  My 3rd lot was delayed because my neutrophils were at 950 The base line for receiving the chemo at my centre was 1400 although the Dr did say that occasionally they will proceed at 1200 if the trend is rapidly climbing.

There is a balance between delaying treatment and missing a 'round' of cell division and letting the neutrophils climb up again.  With the one week delay mine climbed to 2400 by the time I had the chemo.  That was a 4 week gap and the oncologist did not want to extend it further.

I felt no difference post-treatment, nor did I have worse SE than when the count was higher.  If you look at the literature 1500  is given as the figure above which there is no statistical increased risk of infection.

Personally I think you are 'setting your sights' high at 2500 - my count hasn't been there for weeks!

All the best

Isla