Neupogen???

What is a Neupogen shot? and what is WBC?

[mremeet]

WBC = white blood cells. Neupogen is a drug that's taken to boost WBC's, and specifically neutrophils which are a certain type of white blood cell that fights infection (there are several different types of white blood cells). Interferon is known to decrease the amount of neutrophils in our bodies, possibly making us more susceptible to infections. If neutrophils drop too low, your doctor may reduce your IFN dose in order to correct this, which might make you less likely to be cured at the end of your treatment. Neupogen can prevent that from happening by building your neutrophils back up, thereby possibly allowing you to continue on with a full dose of IFN - which obviously increases the effectoiveness of the treatment and the subsequent likelihood that you'll be cured when you're finished.

[jmjm530]

Most doctor's are more concerned with the WBC fraction called
"Absolute Neutrophils" (ANC) than the WBC itself. You should see Absolute Neutrophils listed on your complete blood count (CBC).

They used to think that a drop in WBC or ANC suggested that you were more susceptible to infections, but that advice has been tempered somewhat as studies suggest that treatment-induced neutropenia (decrease in neutrophil count) is not as significant a factor as previously thought.      http://tinyurl.com/ypg2ar

Because of this, many of the more experienced liver specialists intervene later with helper drugs (preferred over dose reduction of the Interferon) such as Neupogen, even with a falling ANC.

The other thing to keep in mind is that ANC can bounce around a lot. Mine dropped as low as 320 but a couple of weeks later was over 1000, without helper drug intervention. My medical team uses an ANC threshold of 200-300 before administering helper drugs. From what I've read here, this is one of the lower thresholds. Other doctors use ANC 500, some 750 and some even 1000.

This is a good issue and something you might discuss with your doctor in advance of any potential drop in ANC. Same thing with Hemoglobin levels and Anemia. The helper drug here is called Procrit (epo).

All the best with your treatment.

-- Jim

[Susie2007]

You are getting great info here. Jim, I got you beat though. My ANC was 9...yup, you're reading that right. And it is true that it doesn't make you more susceptible it just makes it very hard to clear an infection if you get one and have only 9 neuts. Neulasta rescued me but it took a few months. Was kinda scary.

[jmjm530]

I"m pretty sure you mean "900" as ANC is reported differently by different labs.

Check your lab report. My ANC was 320 Cells/mcL

So I think mine was lower, at least I hope it was, cause 9 Cells/mcL is about the lowest I've ever heard :)

But regardless, sure glad the Neulasta bailed you out.

Be well,

-- Jim

[Susie2007]

[Susie2007]

Sorry, fat fingers caused me to post too soon. Nope Jim, that is 9. Just plain 9. At the same time my wbc was .2.  Even the hematologist was surprised. In fact, just to be sure it was the interferon and nothing else, she did a bone marrow biopsy. My bone marrow was so suppressed that my hemoglobin was 7.5 and I wasn't even on ribavirin. It was a pretty scary time. I am back on maintenance and they are watching me closely. So far my ANC is hanging out at around 2,000 so everyone is happy and my hemoglobin is 14ish. My feeling is that I got a sinus infection and that, on top of interferon, lowered those counts. Cause a virus alone can cause anc to drop.

[sfwandwow]

hey i take neupogen shots once a week,they make me feel nausea a tiny bit,but if i eat something i feel better. they raise ur white blood cells, where they drop out onus during tx.. they help me i feel better when i take one..other then that not alot going on..  

[jmjm530]

Susie,

Yikes! You win. That is low. I'm sure even my doc -- who rarely uses Neupogen -- would have prescribed it by that point. Sure glad it all worked out.

All the best,

-- Jim

[jmjm530]

I don't really remember much of your history, but you did just say you were on "maintenance" now.

Another member here, just posted that her husband's new doctor -- also on mainteance -- may be re-considering continuing based on new reports coming out of the November Conference. I believe it will be a final or update to the Halt-C trials, not 100% sure.

In any event, probably something that both you and your medical team should keep an eye out, for as it should give more conclusive information as to whether mainteance therapy is effective, and if so, how effective.

-- Jim