Low WBC after 2 treatments of FOLFIRINOX

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Kbelo
Posts: 5
Joined: Tue Aug 07, 2018 8:19 am

Low WBC after 2 treatments of FOLFIRINOX

Postby Kbelo » Tue Aug 14, 2018 1:38 pm

I'm just 2 of 12 treatments in on a clinical trial using FOLFIRINOX and found out that my WBC count is 0.7, and they've cancelled round 3 tomorrow and pushed it out a week to give me more time to recover. To proceed my WBC needs to be 1.5! Anyone have success with the booster? I heard there can be side effects, and my experience to date is that if there's a side effect, I'll have it. I can't seem to find much on boosting WBC with diet, but any advice is very appreciated!
Stage 3B CC - diagnosed at 40
Bowel resection May 2018
28 nodes removed 1 with cancer traces
FOLFIRINOX started July 2018 for 6 months

violet9583
Posts: 7
Joined: Tue Feb 27, 2018 12:04 pm

Re: Low WBC after 2 treatments of FOLFIRINOX

Postby violet9583 » Tue Aug 14, 2018 7:12 pm

My wife got WBC booster shot couple of times. She was so tired for the next 2 days and also had lot of body pains at that time but it helped to increase WBC count. We talked to an alternative medicine doctor and she suggested this

Astragulus liquid tincture by Gaia herbs: 2 dropperfuls, once daily. Can also place in your hot water with lemon water.

Mystimom
Posts: 4
Joined: Fri Mar 30, 2018 12:42 am

Re: Low WBC after 2 treatments of FOLFIRINOX

Postby Mystimom » Tue Aug 14, 2018 10:13 pm

hello! I also had hemicolectomy in May, plus liver resection. 14 out of 15 lymph nodes were positive, and now have ovary mets.
my onc prescribed me 12 rounds of Folfoxiri w avastin, and 5FU pump for 48 hours , every 2 weeks,.
I get the Neulasta shot for WBC production at pump disconnect. This shot seems to be making me ill. I am aways fine during the chemo infusion, but after the injection I become tired, depressed, nauseous and headachey. This is definitely a strong chemo cocktail! I have done 4 cycles so far...
Was such a shock last March to find out that my supposed appendicitis was actually a burst cecal tumor that perforated the tip of my appendix. Stage 4 out of the blue...

boxhill
Posts: 122
Joined: Fri Apr 06, 2018 11:40 am

Re: Low WBC after 2 treatments of FOLFIRINOX

Postby boxhill » Wed Aug 15, 2018 3:44 pm

Like you, after my first two cycles of FOLFOX I had to take two weeks off waiting for first my platelets then my WBC/neutrophils to rebound to treatable levels. Since then I've been getting a shot of Neulasta when my pump is disconnected, and expect to do so from now on. It has worked beautifully in keeping my WBC count and neutrophils up. I wish there was an equivalent for platelets!

It is important to take claritin daily to combat the histamines that can result--for me-- in severe throbbing pain in the back of the pelvis and breastbone. Even with claritin I've had to take ibuprofen a few times, but it isn't much of a problem. WIthout claritin--I failed to take it the first time--it was nasty.
F, 64 at DX CRC Stage IV (or "3 1/2" per Dana Farber consult, LOL)
3/17/18 blockage, emergency surgery, r hemicolectomy
11 of 25 nodes
5 of 5 mesentery nodes, matted
0.5 cm sub-capsular liver met removed
pT3 pN2b pM1
Neg CEA, neg BRAF, KRAS G12D, germline mut ATM
dMMR, MSI-H, Neg for Lynch
5/4/18 FOLFOX started
Added Neulasta 6/28/18
7/9/18 CT scans show no masses or enlarged nodes, 2mm indeterminate lung nodule

User avatar
mobrouser
Posts: 95
Joined: Wed Apr 11, 2018 1:44 pm
Location: Ontario

Re: Low WBC after 2 treatments of FOLFIRINOX

Postby mobrouser » Wed Aug 15, 2018 4:06 pm

I don't believe there really is anything diet wise that will help with neutrophils.
I was given advice from members here on supplements that might work, but I found it too confusing trying to match possible interactions with chemo and other drugs I was on.
In the end I was prescribed a generic version of Neupogen, which I had to inject daily for 7 days after each treatment.
I was much like you thinking that since I got every other side effect this one would get me too. Surprisingly it didn't.
Hoping you are as lucky as I was.

8) mob
CC Dx Oct 2017 @ age 58
Laparoscopic hemi-colectomy Dec 2017
Adenocarcinoma ascending colon – 6cm x 6cm x 2cm, Low Grade, penetrates to peritoneum
T4a N2a M0, Stage IIIC
lymph nodes 6 positive out of 18
FOLFOX started Jan 16 2018; finished Aug 2 2018 (felt like a year)
CEA - 01/15/18 - 2.8; 07/29/18 - 5.3
CT scan Aug 8 2018 - Clear
PET scan Sept 6 2018 (thought about bringing the cat :wink: ) - Clear

Jannine
Posts: 74
Joined: Wed Jun 20, 2018 7:46 am

Re: Low WBC after 2 treatments of FOLFIRINOX

Postby Jannine » Sat Aug 18, 2018 4:15 pm

I had WBC count of .9 after my first round of FOLFOX; that delayed my 2nd treatment by another week (added up to a month between doses 1 and 2 because of a previously-planned vacation). I'm on an "every other week" schedule. WBC count was back in the good range the following week. After 2nd infusion I got an injection of Neulasta 2 days after disconnect, and I'll be getting those for the rest of my chemo. They were able to let me take the Neulasta home and give it to myself, fortunately, so I don't have to go back to the hospital for that. My WBC count has been good since then.

I did have aching back, ribs and breastbone after the second injection, but not bad enough to need to take something for it. I think everyone's different though. Hopefully it won't get worse for me.
DX: sigmoid colon cancer 5/2018. 48 F
laparoscopic sigmoid resection (24 cm removed); no stoma.
7.5cm adenocarcinoma -- mod diff.
1 noncontiguous tumor deposit also removed; 0/31 lymph nodes
T3 pN1c M0
5/2018 before surgery, CEA 11.2
6/2018 began 12 infusions adjuvant FOLFOX; CEA 3.7
7/2018: CEA 1.9; added neulasta post infusion
9/2018: CEA 2.8
10/2018: CEA 2.4

hiker
Posts: 74
Joined: Thu Aug 09, 2018 10:15 am

Re: Low WBC after 2 treatments of FOLFIRINOX

Postby hiker » Tue Aug 21, 2018 12:55 pm

My WBC went below 1 after my first FOLFOX infusion and delayed my second. I asked my oncologist about diet changes that could help increase WBC, but was told there was nothing I could do except let my body recover on its own. After that, I started on the Neulasta shot at disconnect. You ask if anyone has had success with a booster. I once had labs done 3 days after my injection and my WBC was 32.5 :shock: I'd say it worked a bit too good. It did give me some back and hip/leg pain for a couple days after, but nothing that couldn't be tolerated. As long as I was on the Neulasta, my WBC stayed toward the upper end of the normal range and occasionally went above normal.

hiker
Colonoscopy 2/17, 5cm tumor descending
Diagnosed stage iv, liver mets 3/17
Colon resection 3/17
Told surgery not an option, get my affairs in order
Meet w/MSK team 5/01/17
Folfox(3rds) 5/17-6/17
Liver resection/implant HAI pump 7/17
HAI pump chemo(5rds) 8/17-2/18
Folfiri+Vectibix(11rds) 8/17-2/18
Spot on chest CT 10/17
Lung biopsy (that was fun) 11/17
Nocardia bacterial infection w/spread to brain (this is serious) 11/17
IV antibiotics 12/17-2/18
Oral antibiotics 3/18-present
Clear of cancer since surgery

boxhill
Posts: 122
Joined: Fri Apr 06, 2018 11:40 am

Re: Low WBC after 2 treatments of FOLFIRINOX

Postby boxhill » Tue Aug 21, 2018 2:55 pm

I made a mistake, above. My 2 week gap was between rounds 3 and 4, not 2 and 3.

My NP advised me to eat a rare steak in the second week to bring up my RBC. It works. :D
F, 64 at DX CRC Stage IV (or "3 1/2" per Dana Farber consult, LOL)
3/17/18 blockage, emergency surgery, r hemicolectomy
11 of 25 nodes
5 of 5 mesentery nodes, matted
0.5 cm sub-capsular liver met removed
pT3 pN2b pM1
Neg CEA, neg BRAF, KRAS G12D, germline mut ATM
dMMR, MSI-H, Neg for Lynch
5/4/18 FOLFOX started
Added Neulasta 6/28/18
7/9/18 CT scans show no masses or enlarged nodes, 2mm indeterminate lung nodule

Kbelo
Posts: 5
Joined: Tue Aug 07, 2018 8:19 am

Re: Low WBC after 2 treatments of FOLFIRINOX

Postby Kbelo » Wed Aug 22, 2018 6:17 am

Thanks everyone for the replies and details of your experiences! I am delayed again for another week as my WBC count only went from 0.7 to 0.9 after a week off. I will be getting the booster after my next chemo session, but my oncologist won't do anything until then, so I need to wait for the WBC to recover first. Hoping by next week I'll be back to normal. In the meantime I'll enjoy an extra week off where I don't feel awful. This chemo has really kicked my butt!
Stage 3B CC - diagnosed at 40
Bowel resection May 2018
28 nodes removed 1 with cancer traces
FOLFIRINOX started July 2018 for 6 months

tminor5
Posts: 16
Joined: Wed Jun 13, 2018 11:46 am

Re: Low WBC after 2 treatments of FOLFIRINOX

Postby tminor5 » Wed Aug 22, 2018 7:19 am

My husbands WBC was 3.9 Monday before infusion while it has been around 4.2. I know not bad, I asked him if he had been eating the mandarin oranges still. He said we were out. I was like you have to tell me when we get low. His platelets had also been going down. I made him start eating eggs for breakfast. The vitamin C is suppose to help WBC and protein is suppose to help platelets. He gets disconnected today for round 5. His platelets were 128. Not saying it will help everyone but I hope it is what is helping my hubby. He has a glass (8oz) Gatorade (powdered (4tsp) added to (8oz) water, found at Walmart) in the morning and at supper, a Body Armour drink (16oz) at lunch (it is like Gatorade, but read the label has lots of good stuff), he eats 2 eggs at breakfast, and then a cup of mandarin oranges at lunch (get these at sams has 80% DV vitamin c in it). Otherwise he eats whatever he wants.
DH DX at 46  pT4a,pN1a CEA 1.6
5/25/18 ER suspected bowel obstruction, found infection and diverticulitis
5/27/18 Colonoscopy found colon cancer, couldn't insert stint to do chemo first
5/27/18 Surgery to remove 18" of colon and cancer 1/33 lymph nodes not seen on any near by organs, has colostomy because of infection could reattach after removing tumor
6/25/18 First FOLFOX chemo treatment (12 cycles)


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