Neulasta - every time?
I've received three of six scheduled TCHP rounds (every three weeks). I had nothing after the first round and ended up with Neutropenic Fever and was hospitalized for three days. They decreased my chemo dosages for the following two rounds and added Neulasta as well.
My question is: Does everyone who starts with Neulasta continue to get it each time? I feel like I'm having a lot of SE's - probably from everything. Does anyone just get Neupogen if needed? I responded very quickly to one dose of that in the hospital.
Any input would be appreciated. I couldn't locate anything specific to this on the site.
Comments
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My onc gave me a shot of Neulasta after every round of chemo, just to prevent neutropenia and the problems it brings. Other oncologists hold off to see how the patient responds to the chemo, but I'm thinking it's becoming more common to proactively give it every time. One shot of Neulasta is expensive, but not as expensive as a hospital admission for a neutropenic fever.
Are you taking Claritin to prevent the bone pain that Neulasta causes? It really works.
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I went through 8 rounds of CMF chemotherapy and had Neulasta after all but the first two infusions. My counts were just too low.
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I had four TC's and had Neulasta after each one. My MO took a blood draw prior to chemo. Even a few months after chemo ended, my neutrophils were low. I guess it will vary from person to person. Good luck moving forward!
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I went through 4 cycles of AC, 3 weeks apart and got Neulasta after each treatment. I never experienced any SEs from it. Now, I'm on weekly Taxol and no Neulasta. So far so good, my blood counts are hanging on at the 1/2 way point.
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I got Neulasta the day after each of my 4 DD A/C. Blood count stayed 'better'/higher than 'average'. With the 12/weekly Taxol I got no Neulasta and blood counts stayed well with 'normal' range. Dr said that with my counts what they were during A/C, there was no reason to do Neulasta during Taxol - unless a 'problem' developed which didn't. The only 'issue' that did show up was 1/2 way through Taxol, my K (potassium) level plummeted and it took mega doses of K to keep in 'normal' level. Still 7 yrs later, I still have issues with keeping K level up to normal so it's daily K pills.
The only SE I had from Neulasta was 2 hrs (almost to the minute) after each injection, I would go to sleep for 2 hrs. Wake up feeling fine.
Keepthefaith - It is SOP (standard) for a blood draw to be done before each infusion.
Amapola - I have never heard what a Neulasta shot costs. I paid $8 for mine but I got mine through VA so I pay a set fee of $8 per any script - no matter the cost.
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I had a blood draw before each A/C, 24 hours later a Neulasta shot. Like Kicks, I had 1 hour to get home and comfy. Then I was out for a few hours. That was my only se from that.
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I had TCHP every 3 weeks x 6 and had Neulasta the day after every time. Then since I didn' have pCR, after surgery I had AC every 3 weeks x 4, and again had Neulasta every time. Lots of Claretin - day before & for several days after.
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Thanks for all of the feedback. I guess I'm just tired of taking so many medicines and was wondering if I could eliminate one. It seems like I'm either having side effects from the chemo or else from the medicines designed to reduce side effects!
I talked to the MO office yesterday and it sounds like once they determine that you need Neulasta - you're on it for the long haul. I'm taking the Claritin (2 days before and until 3 after) just in case. I get a lot of aches and pains about 2-4 days after the chemo, anyway. They tell me that's the Taxotere.
As far as cost - my insurance is being billed $4,000 each time. I'm sure that there is a contracted amount that's actually paid. And all of my costs get rolled into a copay so I don't have to pay for the drugs individually during chemo.
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I'm a good example of needing Neulasta after each round of chemo. I had it from the get go for the 1st 3 rounds of TC. We skipped the shot on the 4th round because we'd determined it was Neulasta I was having a severe allergic reaction to. My neutrophils then dropped so low I had to wear a surgical mask at all times until they eased up. I was within a hair of having to go to the ER due to a low fever.
The first signs of an allergic reaction generally are pain in the spleen and on the tip of the outer edge of left shoulder. Instead I had a very intense point of pain deep in my left shoulder well away from the tip. My MO didn't connect this to the begining of an allergic reaction. After the 2nd shot, the rashes developed.
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I have now done 3 of 6 rounds of TCHP and I give myself a Neulasta shot about 25hours after each treatment. My WBC is good so far - Neulasta is part of the standard care at my clinic for TCHP.
I had dose dense AC+T chemo 3 years ago and got Neupogen shots after each treatments for a few days. Insurance did not pay for Neulasta which is more expensive than Neupogen. WBC was never critically low.
I have never taken any claritin and also not experienced bone pain so far.
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They have developed a better way to administer the shot. The picture is actually my insulin pump, but the devise can be programmed to deliver the drug 24 hours later. Then you take it off and toss it. No more dragging your tired self back in for the shot.
A nurse will fill it and stick it on your arm. They are water resistant so showers are ok. There is a small needle and cannula which stays in your skin to deliver med. It feels like a rubber band snap. You never see a needle.
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Spookiesmom, that thing is way cool. My sister told me she had "something stuck on the back of her arm" after her chemo. What a plus, to not have to go AGAIN for ANOTHER stick. Thanks for the photo.
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