RBC finally good, WBC down starting Neupogen?

Talked to my Clinical Coordinator today she said HGB is at 10.5 and looks good (I told her great now bring my Riba back up) But WBC is down to 6.5 and she wants to start me on Neupogen (sp?) Is anyone on this and can tell me about it? and/or does any one have a good link to find out the SX's  

Also I talked to my case management person who is trying to get me to a Hematologic oncologist who will be able to follow my TX and happens to be 30 mins away instead of 4 hrs.  The specialist 4 hrs awway wants to stay my doc but if the closer one can do it all I don't want to travel 4 hrs in snowey conditions this winter just for a half hr appt.  Also from what I understand she will be a little more agressive and allow my riba to stay at the 800/1000 level instead of jumping so fast to 600.  Still mad about that.

[sfbaygirl]

Do you mean your ANC 6.5? Or your WBC? That seems too high of a number for neupogen. Maybe you mean .6 ANC? That would make more sense. I am on Neulasta, similar to Neupogen, and get lots of sx from it. I recommend you stay with Neupogen, if possible. I doesn't last as long and you may have to make more trips to the dr. (unless they give it as a script) but it is worth it NOT TO TAKE NEULASTA! Of course this is my opinion and I know Flguy feels the same.

As far as going to a hemotologist/oncologist, that is a good call. I can't imagine traveling 4 hrs! I go to one and he monitors my blood work much better than my GI would. That is their specialty. Sometimes though with an oncologist you kind of get the perspective of a cancer dr. not a hepotologist, who deals with Hepatitis. I know my hemo has me get Neupogen when my ANC goes below 1.0. Jim's Hep dr. lets his go to .3 or 300. This is one difference.

[sfbaygirl]

I don't have a link for sx for the neupogen, but I am sure you can go to the website. I think like everything else it changes from person to person.

The main sx I know of is bone pain. It is not fun, but some don't get it either. Heat, clariton and pain meds help.

I get major migraines every shot, although my dr. says it's from INF, I only get them when I do the neulasta. So I know it's a sx for me. I am in bed for days after Neulasta, but most people on the neupogen don't seem to have anywhere near the sx I have on Neulasta.

BTW Neulasta is a pegalated version of Neupogen.

[painterlady13]

Hmmmm Looking at CBC right now and I'm not sure what she meant as I don't see a 6.5 anywhere unless she meant the combination of RBC and WBC together... Both are pretty low althouth the red is up.  says here normal wbc is supposed to be at a 4.8 to 10.8 and mine is a 2.6 and the RBC Norm low # is 4.2 and mine is 3.24

Nor do I see an ANC But the neutriphils are supposed to be at 40 - 74 and again mine is 23.5   wow looking at this printout almost everything on here has a high or low flag next to it...  

Hopefully I won't be like you and get the migraines.  I get them when my allergies are bad and they are horrible. I have now done 4 procrit shots and this last week I started getting the bone pain in my legs.  I wondered if a heating pad would work on it... thanks again

[sfbaygirl]

Look for Abs Neuts. It should be under the WBC. Your WBC has gone down, but is not bad. The docs look at the abs neuts to determine if you need Neupogen. ANC stands for Absolute Neutrofil Count (sp)
ANC is part of many things that add up to your WBC count. My WBC hovers below 2, (sometimes like 1.2) but it is ANC the hemo looks at for the neupogen

I told my doc I needed a full body heating pad for the bone pain. Put a wet towel on it and it feels good and is better for your bones. Also strangely enough, the Hemo says Claritin works for bone pain. It seemed to help one day..but who knows.

Hope you don't get those migraines, the bone pain is bad enough.

[sfbaygirl]

Oh man! Please don't tell me I have neupogen to look forward to after tx! How long did you have to do that?

[FlGuy]

To add on to what sfbay wrote.  Neulasta is the pegylated version of Neupogen.  Neulasta acts quickly, like Neupogen but is a little longer lasting.  The downsides to Neulasta are that it is very expensive, compared to Neupogen - but you might get more bang for the buck (I don't think so). But, some people get rough sx's from Neulasta, including bone pain.  Next time, I'm willing to take more shots of Neupogen to avoid the  sx's of Neulasta.  My inusrance will pay for both, though.  I didn't notice any sides to Neupogen, others may.

[NYgirl]

Mine have been low the ENTIRE time I've been on treatment but my doc has kept me off the Neup and I haven't had any problems from it.

I don't wanna do anymore shots than I have to so I agreed.

:)

[GoofyDad]

You can calc ANC by WBC x Neutrophils x 10. In your case that looks like 590. That's getting into the low area - but most aggressive liverheads probably wouldn't consider it worrisome. My docs have a threshold of about 300, but higher (500-750 range) for people like me with cirrhosis.

Some get pretty bad sides from neupogen, but I think for most of us it's just layering on another levl of general funk on top of what we already have going. Generally I didn't notice it too much until I did a few after being off the INF. Then it was like holy cr_p, that's some nasty stuff I've been taking.........

[GoofyDad]

Couple weeks. Took me a while to get running on my own.