Neulasta

Hi from Colorado! I'm wondering if anyone may have experience with Neulasta to increase WBC. I can't seem to find anything specific as to what counts indicate starting it. My problem is that I seem to be tolerating the tx TOO well! After 18 weeks (19th injection will be tonight) neutrophils are 53, wbc is 3.0. Hgb is 12.6, so no Procrit yet. Next hepatologist appt is Oct 6, and I'm wondering if we should consider Neulasta proactively. Last PCR on Sept 8 was clear, so I'll be continuing tx.

[FlGuy]

Don't go lookin' for trouble.  Depending on what scale is used 53 or 530 or .53 docs have different intervention points.  Using the 53 scale, some docs intervent at 100, 75 or 50.  So you might be getting close.  Neulasta and Neupogen are used (aka filgrastim).  Neulasta is the pegylated version of Neupogen.  In my expereince the sx's of neupogen were very mild to non-existent.  Neulasta, on the other hand, brings some nasty bone pain discomfort.  If it were my choice, and it will be soon, I'd take more frequent shots of neupogen rather than the longer-lasting Neulasta.  But that's just me.  The tx sides are enough on my plate.

[FlGuy]

I'm gonna guess that you are a geno 2 or 3 on a 24 week sentence and on 800 mg riba.  When you speak to the heptologist you should discuss the topic of riba dosing.  There is a sort of a theory that riba concentration drvies down you hgb level and the same theory almost says 'riba til it hurts' .  At 12.6 your hgb is fairly high for someone on riba. Again, from my own sorry-ass relapse experience, the second opinion guy though 800 mg of riba was one of the 2 reason for getting a do-over. I get to use a grown-up does of 1200 next time and I tip the scales at about 185, geno 3.

[Micro2]

sorry to jump in...dont want to waste a new thread. My neighbor has end stage liver disease and his wife would like to hook up w/people who are experiencing the same. I know there is a site for this. Can someone provide me with this info? My own hep c has not progressed this far, so I can only support her with limited knowledge.

Thanks, Michael

[westslope]

Please don't get me wrong, I'm definitely not looking for trouble. I very much agree with you that the sx of the treatments are an overflowing plate full. I'm geno 1A, biopsy showed 70% fibrous, initial VL was 3,010,000. I started tx at 206 lbs, and am down to 161. 1200 mg riba daily, and 180 ml Pegasys syringes weekly for 48 wonderful weeks: 18 down (well, 19, in about an hour and 1/2) and 30 to go. If you were on neupogen, how frequent were your injections? From what little I've been able to gather, the Neulasta is weekly, and the bone pain sx affected 31% of patients. I'm of a similar mind, I'd rather do more frequent injections without adding more sx.

[Pdilly]

You might try this site http://janis7hepc.com/.

[GrandOak]

My doc looks at Absolute Neutrophil Count (ANC) which is a function of WBC and other factors.  When ANC goes below 1.0 (or 1000) it's time to consider a rescue med.  Mine hit .7 (700) before I used Neupogen as my rescue med, and my WBC at that time was below 2.

My CBC allows Neutrophil to be between 42 and 72.  Given your WBC is 3, I'm guessing your ANC is not below the 1.0 mark.  So it might be unlikely that a rescue med would be used.

Keep in mind that WBC rescue meds work in days, not weeks like Procrit for low RBC.

[Pdilly]

I am going to see what my 4 week PCR says before I ask to be bumped up from 800 riba.  Hopefully I am responding good and maybe a bump up will help.

[FlGuy]

I had neupogen or neulasta about every three weeks and a cbc just about every Monday.  If Monday cbc indicated low anc's get neeupogen injection that day and Tuesday and Wednesday.  If Neulasta just one injection on cbc day.  Neup /'lasta is not as regular as procrit might be for those with anemia.  With either, tank would go low in 2 - 3 weeks and just do it again.   Think you should mention your riba dose with your doc, since you hgb is not tanking.  Again, not to look for trouble but there are people who metabolize riba more than others.  The dose you are taking is right for your weight though.

[way]

I was askin about that stuff too, until they told me it comes with it's own set of SX.

Then my numbers started to level off and some went back up even. Now I'm hopin to get through TX with out needing it. 8 more weeks.