WBC Still Low

[BrownBagger]

Two weeks off Xeloda and my WBC are still down. Onc says to start back up on the X, but if just three rounds (three weeks total) does this to me, I guess I'm looking at Neulasta shots. Nobody has said that--yet--but I suspect that's where we're heading.

For those who have had the stuff, how often is it administered and is it just a shot or an infusion? I've heard about bone pain associated with Neulasta, though I guess that's not a given. Any other side effects?

I guess I'm jumping the gun here. I won't know anything until I see the doc at the end of the month. Are there any other possible directions she might recommend?

[edinaman]

Eric, I had the shots for maybe 4 rounds of chemo. Mine was 5FU, and one shot was given the day after chemo. I know that some of the women who were on chemo for breast cancer, gave themselves shots for a number of days. I had bone pain. It was in my lower back and hip area. Tylenol took care of it.
Good luck.
Jeff

[janklo]

My daughter always has problems with this - she has to get the Neulasta shot every time. She does say she can feel the pain in her legs and arms, like the bone marrow churning out new cells. But over time we have found that if she drinks a bunch of ENSURE the weekend before chemo, it really helps build up her WBC. Like a 6-pack that weekend is good. And we bought some protein powder and sprinkle it on her food and also put it in smoothies and ice cream. Her onc said protein helps build WBC.

[StarGirl]

Hi Eric!

I had two rounds of Neupogen shots for low WBC. Each series of shots were for 3 days in a row. Shots were not bad, but did delay treatment by a week each time. Had minimal muscle aches. Was told to avoid crowds because of weakened immune system during these times.

Best of luck to you!

[nicola smith]

Brownbagger, I had neulasta shots for the last 5 rounds of FolFox6. I self-injected at home. I had no reactions at all. I had been told to take Claritin if necessary, but it wasn't. I confess to some nervousness, though, knowing that I was self-injecting with a drug worth $2-3K a pop!

[hopeful]

Brownbagger, my husband had Nuelasta shots during his Folfox treatments. He would get the shot the day the pump was removed. He never had any reaction at all, except that his WBC jumped back up. I think he probably had 5 or 6 over the last months of his chemo. He was 62 at the time, 6 foot and about 170 lbs.

[abuttigi]

Hey,

My dad has been getting Neurlasta shots for awhile now. His routine is as follows:
Chemo Tuesday, pump of 5-FU for 48 hours. Back to the hospital on Thursday for pump removal, then back again Friday morning for the Neurlasta shot. It literally takes 5 seconds and its worked miracles for him... his WBC count hasn't been low since he's started!

Hope that helps,
Angie

[Karen32]

Hi Eric,

I received Neulasta shots from round 4 - 12. My onc gave them 24 - 48 hours after disconnect. In the beginning I would experience bone pain across my shoulders and neck, but only noticed it when I laid in bed at night. In later rounds I had discomfort in my femurs. Nothing that was bothersome or even nagging. The only problem i had with the shots was the inconvenience of having to leave work to go back to doc's office.

Good luck!

[jmarie]

I had to get nuelasta about 6-8 times over the last few years. The bone pain was pretty bad, but at the time I had never heard of taking Clariten for it. For me pain meds didn't do much for thebone pain, it lasted a few days usually and seemed to be worse in cold weather. I would go in for just one shot, but for those whose insurance wouldn't cover it had to do the nuepogen shots 3 days in a row.

Whenever I did the shot my WBC seemed to hold up for quite a while afterwards, I think that two of the times I got the shot as a pre caution before traveling. I hope it helps and that maybe just one shot will get that blood marrow working for a long time!

[juliej]

Eric, since you're taking Xeloda on the one-week-on-one-week-off schedule, do you mean you've been off for 2 cycles (4 weeks) or just missed a week of Xeloda?

I'm not sure what to make of your low WBC. Sometimes the body sort of "adjusts" to chemo, so it could come back up all on its own before your next appointment in NYC. Or it could relate to your vigorous exercise program. Have you been putting in some serious mileage on the bike lately? Did you get a flu shot recently? Is your absolute neutrophil count (ANC) low too?

[BrownBagger]

I just skipped a week, but she let me go back on today. Sure, I've been riding as much as possible in this beautiful weather, though I did abstain the weekend before my last Monday blood draw. And no, no flu shot--yet. I'm hoping they can do that for me when I'm down there. The chemo nurse told me to watch for fever, although I feel great--and have since I started taking the Xeloda.

[juliej]

I'm on my 21st cycle of Xeloda without a break. I have felt great the entire time. Any slight nausea was stopped by exercise, either running or riding my bike. I'll be stopping this cycle early - 2 weeks ahead of surgery. It will feel weird not to take those big pink pills.

Check out your MCV (mean corpuscular volume) in your last CBC panel. It should be elevated on Xeloda. It's a biomarker of adequate dosing to make sure you're getting enough for tumor response.

[Krisd1907]

My onc recommended the claritin for the pain, and she told me to take it starting day of treatment and to just take it daily throughout the treatment to assist with the pain. She did say it could be generic - and I found it cheaper (400 pills for $10 compared to 90 pills for 25) at Sam's club.

I will be getting the Neulasta shot every other treatment initially and if my WBC go low I will get every treatment during my chemo -which is FOLFOX. I start next week, so can't tell ya anything about pain, but hoping to avoid that issue with the claritin. My mom had extreme pain with the shot.

Kris

[Mona]

BB, I have been getting Neulasta shots between my last couple of treatments. I start taking them one day after finishing my cycle. I took 2 or 3 of them. My husband was nurse, not the best one, but he tries.
Much love,
Mona

[Icesk8tr]

Eric,
I gave myself Neupogen shots 3X a week on off chemo weeks. Many people tolerate Neupogen better than Neulasta. It was also nice to NOT have to go back to the treatment center for one more thing!
Good luck

Christine