Neulasta with TC

MTNCLMBR

I see many people on here talking about how they take neulasta with Taxotere/cytoxan.

I have only had one treatment so far, but my doctor did not give me neulasta. He said they'd check my counts before my next treatment. Does that seem normal? If so, can anyone with experience tell me WHEN in the course of your TC treatments that your WBC went low?

I only have to have four treatments total.

NotVeryBrave

My MO also did not automatically give me Neulasta but chose to wait and see what happened. My WBC plummeted about Day 8. I ended up in the hospital due to low counts with a fever and was given antibiotics and Granix there.

I ended up receiving 25% less in subsequent rounds as well as Neulasta before switching to Neupogen. No further problems with Neutropenia.

DebAL

hello, I have had 1 out of 4 TC treatments as well. Got neulasta but almost didn't due to insurance. It is not always used and some patients have an extra lab or 2 drawn before the next treatment to be sure things are ok. Some get neupogen. My understanding is that you are the highest risk of your wbcs decreasing near the last 10-14 days before the next treatment. Maybe your MO will offer it with the rest of your treatments? Dont hesitate to ask questions!

Melrosemelrose

My oncologist told me that i would receive Neulasta shots if and when it became necessary. Ten days after my 2nd round of chemo, I developed a high fever and chills. As I recall, the fever and chills started on a Sunday. My husband called my oncologist who ordered antibiotics for me which allowed me to avoid a emergency room visit. The antibiotics did worked and I was able to have my 3rd round of chemo on the scheduled date, the following week. I started receiving a Neulasta shot the day after my 3rd round of Cytoxan/Taxotere and continued to receive them after rounds 4-6. The onset of the high fever and chills did occur during the nadir period which is the considered the lowest point that a chemo patient cell count reaches after receiving a round of chemo. That one incidence of fever and chills was the only incidence of fever and chills I experienced after a chemo round. Blood lab work was done the day of chemo so I was always knew what my counts were before I had the chemo round.

Wishing you the best with the rest of your chemo rounds!!!!

Debsmisto

I'm on Taxotere and Carboplatin and was automatically put on neulasta from my first infusion

OCDAmy

I had four rounds of TC and never had neulasta. My counts remained pretty good through treatment and my MO doesn't automatically give it.

NotVeryBrave

I should add that my MO initially put me on an oral antibiotic the day they found my counts were so low. Later that day the fever started. We waited 24 hours to see if it would resolve. They sent me to the hospital when it didn't.

I'm not a fan of giving the stimulating meds automatically - even though I spent 3 days in the hospital on strong antibiotics. There are possible serious SE's from them and why use something with a risk if you don't need it?

But everyone should be very cautious about low counts. It was explained to me that the bigger concern is not "catching" something out in the world, but having your own gut bacteria escape into your bloodstream and potentially cause septicemia.

My ANC was 2 - both immature - on admission!