Hi Lynda,
There are different opinions about low ANC's (the partof WBC's to keep an eye on).
Mine bounced around a lot during tx. My doc let me go to 300 and then it went back up on its own, without neupogen or dose reduction. I never did get sick with a bacterial infection but several here did and took antibiotics.
Neutrophils are your major defense against acute bacterial and some fungal infections and docs have different thresholds for neutropenia caused by interferon. Since you're in a trial, it's to your advantage that you've been offered the neupogen, and now have a choice.
If your neutrophil count falls below 1,000 cells per microliter of blood, risk of infection increases somewhat; if it falls below 500, the risk of infection increases.
And yet there are studies that say that interferon-induced neutropenia does not lead to greater infection.
Aliment Pharmacol Ther. 2009 May 1;29(9):1000-10. Epub 2009 Feb 7:
"CONCLUSIONS: Bacterial infection during peginterferon-based therapy for CHC was associated with comorbidity of cirrhosis, but not with neutropenia, whether at baseline or during treatment. Neutropenic CHC patients might be treated safely with close monitoring."
Infection. 2008 Jun;36(3):250-5. Epub 2008 May 3:
"CONCLUSIONS: During the treatment with pegylated interferons and ribavirin, we did not find a correlation between neutropenia and infections. This result provides a support for the notion that current guidelines for pegylated interferons dose reduction in the treatment of chronic hepatitis C for hematologic toxicity could be overly strict."
Here are some threads voicing different opinions:
http://www.medhelp.org/posts/Hepatitis-C/Need-advice-should-I-say-yes-to-neupogen/show/340785
http://www.medhelp.org/posts/Hepatitis-Social/Question-for-JmJm530---neutropenia/show/42043
Susan