can rescue meds all of a sudden stop increasing counts

[sheri1968]

have been receiving aranesp and neupogen for the last 8 weeks to help with my anemia while going through treatment. My wbc, rbc, hemoglobin and ANC held steady for the first few weeks, then started increasing and now as of last week took a decline. My wbc's went from 3.4 to 2.3, rbc's went from 2.9 to 2.7, hemo went from 10 to 9.33 and ANC went from 1770 to 930 all in one week. Is that normal and why would that happen when they were on the incline?

[newleaf09]

I recall that when I started the neulasta (pegylated form of neupogen that stays in system longer), I was required to come back next day for blood draws to see if I responded to it and how well I responded.  Towards the end of TX, the effects (holding my neuts above danger level) lasted a shorter time, so I guess the blood helper drugs may get less effective but they did still work.

The neupogen (or neulasta) works overnight.  Other posters (was it nygirl?) used neupogen twice a week to keep neuts up.  The procrit always takes several weeks of continuous weekly shots to start raising hemoglobin levels.  When I got near 11, I would always be taken off of it, which always broke my heart because it meant hgb would decline again and I'd have to start the weekly shots and climb again.  Same with the neulasta; when my levels jumped up to safety, neulasta would be stopped and I'd have to wait until they crashed before I was okayed to use it again and get that big overnight resolution. Your doctor should be able to fine-tune your helper drug dosing schedules to keep you in the safety zone.  

Using the helper drugs means lots of extra blood draws but you get pretty accustomed to being a human pincushion on TX.

[nygirl7]

I don't know about neuts and neupogen either but with the Procrit (I was on epogen) once a week did not work for me so we had me doing twice a week (which finally started to raise it too high) and then we backed it down to every 5 days.  This kept me in the 10.5 range which believe it or not isn't that bad.  On the way going DOWN it's much much more terrible but once you get it up over 10 it's ok.

[skersj]

I don't know about Neupogen but 40,000 units of Procrit originally raised my counts to get me out of the danger zone but never raised my Hgb much. Hgb bounced from 8.4 to 9.3 for highest count for the last 9 months of Procrit. Maybe it doesn't work as well for everyone. It got me thru treatment though.