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Is it appropriate to give cycle 2 R-CHOP without Neulasta support if nadir ANC was 500 on cycle 1?
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351246 tn?1379682132
The Nadir or low point of absolute neutrophil count is usually seen after about 7-10 days of the chemo cycle. Usually this returns to normal or near normal and the next chem. Cycle is started. But a nadir ANC of 500 is a grade 3 or 4 risk (high risk) for infection and should be ideally supported with Neulasta, unless there is a contraindication such as sickle cell disease, possibility of splenic rupture, tumor having granulocyte-colony stimulating factor (G-CSF) receptors which get activated by Neulasta, or other such conditions. In these cases usually packed cell transfusion is given.
Hope this helps. Take care!

The medical advice given should not be considered a substitute for medical care provided by a doctor who can examine you. The advice may not be completely correct for you as the doctor cannot examine you and does not know your complete medical history. Hence this reply to your post should only be considered as a guiding line and you must consult your doctor at the earliest for your medical problem.

Avatar universal
Thanks for the information. This is what my nurse colleagues & I thought. We just wonder why a physician would not do whatever possible to hopefully prevent complications of neutropenia especially since this was cycle one. There are no known contraindications for Neulasta support.
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