RATS! neupogen question

[slarso]

Well my Doc works Sundays, He must have felt quilty from being gone for 5 days!. He called me and said that mt WBC was at 2.0 and Neutrophil% was at 26% It has been steadly declining since shot 1. Other than that, I am doing well, I am at 8/48 pegasys/co-peg. SX are minimal, some fatigue, some insomnia and some rash. I regularly exercise for an hour or so, and eat a good diet. I am assuming the IFN is causing the problem So, what is the experience out there with neupogen? is it a slam dunk and folks always take it when they get critically low WBC. And do you take it for the duration of TX? Are there sides? I would rather not dose reduce or stop tx, thanks for the help!

Steve

[Ambush]

Steve, I don't know much about Neupogen, but my WBC has been hovering around 2.0 since July (started tx in May '03) and leveled out there.  The drop was steady from May to the end of July. I think that's acceptable as long as they watch it.  Maybe you'll settle there and won't have to go the Neupogen route?
ambush :)

[hph5477]

My WBC was at 2.3 at my 8 wk labwork.... go for my 12-wk labs this Thursday.  My dr looks at doing the additional shot/help if I drop as low as 1.5.  She also told me that if I make it thru the first 8 wks with my numbers in range, that I should make it thru the whole tx so we'll see.
...Just curious, are you still getting a lot of exercise?

[slarso]

I do still get a lot, maybe 6 hours a week, although not very intense. I will bring it up with my Dr.The drop in WBC has been steady they a percipitious last week. The vampires hit me tomorrow and I'll let you know what happens. I hope it will level off

Thanks

Steve

[txpartner]

hubby took the neupogen with few sx. however, our insurance did not cover the cost (very high...3500+ for 10 preloaded vials).  the manufacturer, however, had oneof those plans for the uninsured or underinsured, that reimbursed our pharmacy for the meds...whew!  good luck.  carol

[odessit]

Hey,
neutrophils at 26% = 0.52 which is low! they usually stay around 50-60%. Obviously Neutrophils effected by IFN and Neupogen will boost their production.

My WBC were steadily dropping till week 12 ( WBC 2.1, Neutrophils 0.9 ), then at week 16 they went up - WBC 3.6, Neut 1.7.

[OkieJim]

I had to take Neupogen at week 8 or 9 I can't remember. My neutrophils had dropped to .68. It was only a temporary fix. Dr. had me do 1/2 cc twice a week. I did it on Monday then Weds. then Pegasys on Friday. He had me do it for two weeks. Two vials. SX's were it really stings if you don't get it warmed up before injection. Bones ache like the flu for a day. That was it. It did the job. I just finished a second bout of it a week ago. I don't see Dr. for another 4 weeks so she can't RX more for now. I just did shot #18 on Friday. We are close. This has become a normal thing on TX this year. The neutrophils are the cells that help fight off infection. They are part of the White Blood Cell compliment. I hope this helps oh also it is a thick syruppy liquid. Air bubbles rise to the top of syringe slowly when cold.

[raheem]

My WBC has been around 1.2-1.5 and ANC around 500-700 for 4 months. After 30/48 weeks of tx, my ANC dipped to 444 so the doc reduced the interferon dosage 25% to 135mcg.  He said a dosage reduction of interferon at this stage for me should not effect the response rate....as opposed to dropping the ribavirin dose which clearly reduces the response rate. I don't think a dosage reduction would be the way for you to go after only 8 weeks.  My doc is not a Neupogen advocate.  Be mindful that your bloodwork can drift up and down quickly. Also, if you have a blood test a day or two after your interferon shot it will probably register a lower WBC and ANC. I'd say remain vigilant regarding your lab values, wash your hands frequently and stay away from sick folks, if possible. I'll be having a blood test shortly to see how much my WBC came up from the interferon dosage reduction.

[GALLIUM]

not to sure what i will do as my wbc hangs at 1.5 to 3 all the time and neutrophils at around 20-30% all because of the leukeamia.
might have to go on revers isolation during treatment lol.
havent looked into the nuepo but we use it a lot in the hospital where the wife and i work.

[GALLIUM]

asked the wife about this since she is an icu nurse she has better info about drugs than i do.
nuepogen works better on neutrophils ( also know as filgrastim so you could do a google on the drug).
there is another in this class that works better on the red cells called epogen(epotin alfa)
you might do a search and get better info on these drugs.
hope this helps

[Galen]

I did Neupogen once a week from week 8 through week 48.  My counts never did come back to normal levels but were hovering aroung 1.0 with the Neup. I also was put on Procrit every week at the same time.  Toward the end of tx, the Procrit was upped to twice a week.  I found that the Neupogen gave me bone aches that would kick in about 24 hours afterward for a day or so.  Whoever said you can't have too much fun!? Anyway it beats dose reduction and I am still clear.

[Tri-guy]

Steve, those counts are really getting low.  Hope the dr can help you get those up back up.  I had talked to my dr before I started tx because of previous experience with low counts and she was on the fence between dropping my dosage vs procrit if my counts went to low.  As for as using procrit she told me the counts usually recover pretty quickly but some of the comments on this post seem to contradict that.

[berlynn]

Hi, my wbc was about the same as yours (2.0)when I had some bloodwork done at the ER for some sx problems that I was having....they said that my doc should put me on neupogen.....My doc said that I was borderline and he preferred to wait....well my next bloodwork showed that my wbc went down to 1.6 and the neutros down to .8....my doc called and said that he was concerned and calling me in a script for neupogen to start right away.  He had me do 1 shot once a week...so far I have done 4.....I have felt really sh!!!y over the last mos and I'm not sure if it's the neupogen,,,the low WBC's ...or just the tx.  Good luck, berlynn