wbc very high after shot

[toby47]

Should I be concerned my wbc spiked to 22 after neupogen shot and a reduction in pegys to 135.Does it do you any harm for that to happen. They gave me the shot when my wbc was 2.2. I've been getting 2 or 3 shots for the last month and its always stayed in the range of from 1.3 to 3.6.

[toby47]

No  it wasn't wbc was 21.5 and anc was 18.9 that was tues. on thurs it was 2.2 and 1.1

[James10500]

Sounds like a decimal point is off.

[toby47]

You are right 2 days later I was back at wbc 2.2 and anc1.1 that was following day after my inf shot.So all those immature cells were killed off by one shot.Everybody's may spike ,we just don't know it unless you get a cbc after the neup but before your inf shot. Thanks.

[hcvJames]

I took Neup for most of the tx. In the beginning I wasn't given a schedule so I followed the instructions on the labeling which were to take a shot every other day. I took a Neup shot on Fri, another on Sun., an a CBC on Mon. A Neup shot on Tue and Thur. For reasons not worth getting in here I stopped on the fourth shot (I had six vials). On my next appointment they were alarmed the WBC count was over 23. Ha, well they could have given instructions b4 hand, followed up to find the effects and set a maintenance level, etc. Imagine what it was after the fourth shot! Anyway I figured to take my Interferon shot on Wednesdays and Neup on Sun., and CBC's on Monday. That way I'd always have a high WBC count, usually 12 to 14, and they wouldn't have an excuse to stop tx. In short WBC will shoot up right after a shot, but after 2 or 3 days it drops like a rock. Well that was my experience, mileage varies. In your case 3 shots does sound excessive.
The thing about WBC and ANC .. Neutrophils are components of WBC so if WBC is high or low ANC follows in a rough range. ANC is a bit of a refined number compared to WBC. I don't know if I'd chunk the doc over his use of one over the other unless you bring it up and he doesn't seem to have any idea what you are talking about.

[orphanedhawk]

The decision of whether or not I need neupogen is based on my anc, not my wbc. I've had wbc under 2 and not had to do neupogen.
In my case, if my anc, are less than 750, I take neupogen.
My heptalogist is pretty top notch. I'd question yours, to be quite honest.

[toby47]

I haven't needed 3 neup shots a week in 3 weeks, prior to that I did get  3 shots a week for 4 wks.The shots are also 480 dose.I have all my blood tests except for this last one,which I'll p/u t'mrw.Reduce the inf for 2 wks to allow wbc to stabilize some because i had been getting 3 shots a week. It obviously worked too well. Today I'm back to 180.

[toby47]

They do a cbc prior to shot, the last time my wbc was 2.2 which seemed a little high do to the fact That it had been a week. usually its in the low 1's with anc bx 300 and 600.lately last 2 weeks have been getting 2 shots a week mon. and thurs with inf on wed.This happens at hemo off. I had gotten a cbc with metabolics and tsh for Gi Office , get that done every 4 weeks.So thats why I know the wbc count bx shots.Obviously the reduction in inf was the cause for the spike as that hadn't happenned before. Hope I will be able to reduce neup to once a week cause it costs a hundred each time.Of course I'll find out tommorow wher its at again.Usually just two cbc a week at hemo off.

[flcyclist]

The reference range for wbc's on my data report is 4.2 - 10 K/uL.  If your wbc's are 22 K/uL, then it's way out of range.  Do you know how much neupogen you are receiving per shot?  Can you tell us why your doctor did the interferon dose reduction?  

I receive 480 mcg of neupogen 2x per week and have had no dose reductions.  Prior to each shot they run a cbc to check the levels.  What they focus on is the ANC (or GRAN), although the wbc's are directly related to the ANC.  You should request and keep a copy of each of your cbc's to keep in your own file at home for reference.

I'd also guess you won't need the neupogen, but after the interferon shot, the numbers sometimes drop dramatically.  With the high wbc numbers, I'm a bit surprised you need 3 neupogen shots per week.  Keep a close eye on these numbers.  Good luck

[frijole]

I am still confused.  You are getting weekly CBCs or do they do a CBC after each shot of neup (that would be a heck of a lot of shots).

Can you give us a little track record here -- and give your absolute neutrophils and the WBC.  Is it a GI, hepatolotist or hemotologist that says to do 3x a week?  

WBC if 22 is still awfully high and it sure seems like you could take your full dose of interferon.  I am like sandy -- trying to figure out if your doctor is over reacting.  I treated for 56 weeks and my WBC was very seldom over 2.  I took one shot of neup per week.  I don't know if that helps at all, but unless your absolute neutrophils are staying under .5 even with the shots, my opinion is that you should reduce the neup.  

[sandysf]

2-3 shots per week might be a bit much.. in my opinion docs over do this.  How do they KNOW you need 2-3 per week, is your blood monitored that often or are they guessing?  

[toby47]

It's been 2 or 3 shots a week, thats why the reduction to see if I could stabilize a little. My pegys shot is today so i'll see what its like on thurs.,guessing I won't need a shot.Feel okay though no problems. No doc to speak too but I have the sound wisdom of office staff letting me know its probably not a problem.

[frijole]

Did you see the actual CBC?  That does sound pretty high but I don't know of any danger.  I knpw that neupogen is fast acting but is sounds like you have been monitored pretty closely if you have been getting -- is it 2-3 neupogen shots a week, or month?  What does your doctor say?

frijole