Thank you Dr. Saini for your response to my prior inquiry a couple of days ago. To follow up-- Hypothetically, if one gets a herpes outbreak during a treatment period of chemo infusions, would that outbreak cause postponement of the next infusion? Or be dangerous if the patient had low wbc during chemo (and cannot take neulasta or neupogen due to severe allergy)? I'm not on chemo now, and I might never be again, but I'm looking for answers to these questions in case I ever have to be on chemo again--esp. in light of wbc issues and my neulasta allergy. I don't have herpes (I have been blood tested) but my husband has been having herpes outbreaks a few times a year. He takes valtrex occasionally but is reluctant to go on an antiviral drug on a regular basis. My understanding is that someone carrying the herpes virus is contagious even when not having an active outbreak. Vaginal pain post-chemo makes condom usage difficult. I'm trying to weigh the various risks if we stop using condoms, given my hx with brca (dx 2 years ago--stage 1, 1 cm. mostly-invasive ductile carcinoma, grade 3, e.r. positive, node negative; I had lumpectomy, sentinel node biopsy, 1 taxotere & 6 CMF infusions, 7 weeks rads, 1 year tamoxifen, and now arimidex for the past 6 months or so; during chemo, I also had several postponements and dose reductions due to low wbc; my wbc now, 1 1/2 years after end of chemo, is 3.2 (with neutrophils in range). wbc dropped from 4.8 to 3.2 in last 9 months. Don't know why --I haven't had any infections, as far as I know. Thanks for yfour help. God bless you too.
During chemotherapy, any infective episode, including herpes, may lead to postponement of next cycle. Typically, low WBC is more related to risk of bacterial infection (esp Gram negative bacteria) than viral infection.
I hope you never need chemo ever again. You had a small sized primary tumor, node negative, receptor positive disease - these are all good prognostic features.
It is unlikely that the chemo is responsible for such prolonged leukopenia. Maybe you should consult a hematologist at some point.
All the very best.
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