WBC, Neulasta, Neupogen, etc.

My understanding is the Nuepogen is faster acting but the effects don't last as long - so more shots are required.  One Nuelasta shot keeps the wbc up until the next tx.  

My onco has me get a blood test weekly to test blood counts.  I get the Neulast a few days after my chem tx because my tx are on Friday.  After my 1st tx, we found out that my WBC drop more quickly than typical and the Neulasta wasn't having time to "kick in" so I now also get 3 Neupogen shots the week after tx too.  With that regime my wbc have stayed in a good range.

I go into the office for my shots.

Tamara

I did lots of IVF and so I am accustomed to jabbing myself without too much trouble!

The odd thing about WBC is that when I felt really unwell my WBC was ok and when I felt terrific they were too low!

In the UK they wait and see how you are going to respond to chemo - not everyone needs them.

 I am taking Neupogen - every other day from Day 7 post chemo - and I really dislike the side effects - throbbing aching rib cage and pelvic pain. But they are are necessary evil to get me through chemo without any more delays.

The WBC is part of a CBC (complete blood count), a test to determine your WBC, RBC (red blood cells) Hemoglobin (oxygen carrying component), Hematocrit (% of red cells in your whole blood [rbcs & plasma]) and PLT (platelet count - platelets are the first responders to repair damage in the vascular system).  All of these cellular elements are fast to replicate - so they are effected by most chemo drugs.  The WBC (white blood cell count) is a total count of 5 different types of white cells; neutrophils, lymphocytes, monocytes, esosinophils, and basophils.  The WBCs that are most important in launching an immune response are the neutriphils.  The ANC is the absolute neutrophil count and basically represents the total number of neutrophils in your system.  You may see it on a report as NE# = 1.0  (10 to the 3 exponent per microliter) which translates to 1000 neutrophils.  My ANC went down to 0.2 (= 200) and my total WBC was 2.1.  Usually your counts will be their lowest on the 10th day after a chemo treatment - this is the Nadir.  I will list the normal reference ranges that we use in our laboratory - each laboratory establishes their own normal reference ranges using an average from sampling their normal patient population; most reference ranges do not vary by much. Ranges for certain elements vary for male & female (I will note this using M & F).

WBC (white blood cells)      M/F     4.5 - 11.0  (10 to the 3rd exp)/uL (microliter)

RBC (red blood cells)          F         3.50 - 5.50 (10 to the 6th exp)/uL

                                        M         4.30 - 5.90 (10^6)/uL

HGB (hemoglobin)              F         12.0 - 16.0 g/dL 

                                        M         13.5 - 17.5 g/dL

HCT (hematocrit)                F          38.0 - 46.0 %

                                        M          41.0 - 53.0 %

PLT (platelet ct)                 M/F       130 - 500 (10^3)/uL

ANC (absolute neutrophil)   M/F      1.8 - 7.7 (10^3)/uL 

My oncologist only orders Neulasta when indicated.  Hope this helps.

Donna                                

Since I will be traveling on business trips with a lot of people, I asked my oncologist about Neulastin (because that was the one I saw mentioned here most). She usually doesn't give either unless the counts show a need. She also said that on my treatment, TCH, white cells dropping to low is less common (the BCIRG-006 trial apparently showed the white cells dropping low about 2/3 of the time but fever or infection about 1/10).

She prefers to give neupogen. She said that 1 neulasta is like 10 neupogen does so it can be too strong. Having too high a WBC can cause problems particularly for the spleen. Also it tends to have less side effects (e.g. the bone pain) than neulasta. She said that I would probably need about three shots neupogen per cycle if I needed it and they would teach me how to do it.

Avalon 7167 - This Thread has not been posted on for 9 yrs til you. It is often easier to get more posts if you start a new Thread.

I did 4 DD A/C neoadjuvant 8 yrs ago and did Neulasta. My WBC count never lowered. I went everywhere/did everything I wanted to (very much out in public places/events) and did not have any issue at all with 'catching anything'. I did 12 weekly Taxol adjuvant (without neulasta) and my counts stayed fine doing/going everywhere throughout and did not 'catch' anything.

Actually Chemo apparently kicked my immune system into 'gear'. 'BC' (Before Chemo) I 'caught every cold that was going around and as long as I can remember, I would have several severe sinus infection every year. In the 8 yrs since starting Chemo, I have had 2 minor sinus infections and 2 'colds'. So for me, I got an unexpected positive.