I was supposed to do a shot tuesday, however got bloodwork done today and anc is 620, Doc says to take neupogen tonight (I did, the neupogen is 300mcg, im ~130lbs) and get more bloodwork done on thursday, and then he'll call friday with whether or not to take the shot or not. So here I am, waiting, again. Arggg!
So I stopped the shots and decided I would wait to do the CBC weekly. On Tuesday my ANC had dropped to .3 so I did the neupogen on Wednesday morning and did my interferon on Friday morning as usual. From what I can tell the neupogen works fast and then leaves my system just as fast.
I let the neupogen sit out for about 15 to 20 minutes and don’t shake it b/c it’s syrupy compared to the interferon and the bubbles that come from shaking won’t leave so you’ll have to throw away that vial.
However, under hep C treatment you can actually sustain a much lower ANC without risk of infection. I believe 500 is a borderline ANC for starting neupogen. I will look for some studies to post.
You will never never get your ANC up to 5000 on treatment. Even with neup my ANC stayed about 800, sometimes 1000. Remember, that you want your neutrophils built up to fight infection but if you are not prone to infection (and summer is better than winter) than, 830 may be just fine for you.
no but i did start with very low reds and i am just about ok , well not really but not on rescue drugs anyway
//www.medhelp.
Ask for the ANC and then ask for Neupogen. IF you should develop a problem with the hemolytic anemia as well you ask for Procrit. These are the two helper "rescue" meds we use so we do not have to dose reduce and they both are very good at fixing the problems (although the Procrit takes longer to work so you want to stay on top of that number).
This is why we ALWAYS advise you get a hard copy of every single test you have taken...
Bill, many experienced hepatologists use the ANC threadhold of 0.5 before administering neupogen. You might have other issues going on which led to your doctors decision to begin earlier at 0.7. Some doctors use 1.0 for the threshold for fear of risk of infection, but there are many published references to dispute this risk for HCV patients. For cancer patients? yes.
My ANC was often 0.3 or below and I was taking two neupogen shots per week.
ANC bounces around but if your blood tests are consistently showing a downward trend in your ANC, your doctor may recommend Neupogen which is a rescue drug given once ANC drops and stays below 500. Different doctors have varying thresholds as to when they think Neupogen is necessary. Very common for whites to tank on treatment.
My doctor seemed shocked, but pleased,....Well, I decided to go with my doctor...and as of this week my very low 600 ANC is now 1500.
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Not trying to sound facetious, but you might point out to your doctor that ANC can bounce around -- forget half a dose, even no dose. My ANC was 300 one week and two weeks later is was around 1200. No Neupogen. Is your doctor a hepatologist?
Two wks ago I got the same call from my HCV nurse...she told me my WBC 1.4 and ANC .5 were to low so I had to take neupogen 480mcg 1/wk. She also told me not to take my INF for that week until my ANC went up some. I took my first shot of neupogen on a sat evening and had my cbc on wed. My ANC and WBC went back up to a normal range after just one shot so it does work fast. I did take my INF as usual on the following friday 4/4/08.
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