WBC spike after Nuelasta/Fulphila

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Has anyone who had the Fulphila or Nuelasta shot had an overproduction of WBC? I have had labs drawn the last 3 days due to high heart rate issues, and yesterday my MO was confused by my numbers and today they are even higher.

My WBC count is up to 34 k/ul (lab says normal high is 10), my Neutrophils are over 26,000 ( normal high is 7,500) and my RBC are falling below the normal low mark. Anyone else have something like this show up? I had my first Fulphila shot 8 days ago.

My MO is confused as to why they are so high but is saying she thinks its from the shot. I am concerned about possible side effects from having too high of WBC and my RBC and platelets are falling

Comments

  • YesIamaDragon
    YesIamaDragon Member Posts: 363
    edited March 2021

    Are you getting steroids with chemo as well? That can do it. Especially in combination with the neulasta.

  • SpecialK
    SpecialK Member Posts: 16,486
    edited March 2021

    Your RBC and platelets will be unaffected by the Neulasta and falling is expected because they are negatively impacted by the chemotherapeutic agents. You may see a kind of up and then down result like a drop, then a bit of recovery before the next infusion, then another drop ultimately trending in a continually lower net result. This is pretty normal and not super alarming, but watch your hemoglobin and be aware of the signs that it is too low - lethargy, dizziness, shortness of breath. That threshold is different for everybody so don't get too attached to a number, rather check how you feel. Be sure to report any of those to your MO asap if you feel them. Make sure you are ingesting enough protein - even though I didn't like the texture I did try to eat more red meat and other sources of protein in the two weeks prior to the next infusion after the GI distress calmed down immediately after chemo and Herceptin. I did experience spikes from Neulasta, above the range, and that is also not unusual. These meds create a stimulated manufacture of WBC in order to protect you from opportunistic infection, but you may just be a super responder with a more robust than usual reaction. Sometimes you can also have an infection whose WBC response is masked by the drug, so also pay attention to any other symptoms like congestion, coughing, etc., and let your MO know if you have those. Sometimes administering an antibiotic is necessary to potentially treat infection that is simultaneous. If that is the case I would not expect for you to see this after each infusion. Wishing you the best.

  • LoveNow
    LoveNow Member Posts: 27
    edited March 2021

    SpecialK and Java thanks so much for your input. Very good to hear it is likely I am just a "super responder" :)

    I called the MO on call and she said that as long as I am not having symptoms like fever, coughing or extreme weakness (which I am not) it is probably just the shot.


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