White Blood Cells

[LindaH]

I went for my Chemo this morning and they nearly didn't let me have it.....eek

They said my white blood cell count was low. It was 1.3, but they like the count to be 1.5, so they say if it hasn't recovered by my next appointment on 24th, I won't be able to have Chemo until the count recovers.

I'm apprehensive about going without Chemo, I'm worried the tumour will also recover which I didn't want.

Is there anything I can do to boost my white blood cell count? People recommed B vitamins which I alreday take, Royal Jelly, Folic Acid, red meat and cauliflower.

I would certainly appreciate any comments please?

Thanks

Linda

[KATB]

I wonder if Jeni can help - I know in other cancer types Neupogen is given (or another GCSF) but I've not heard anyone mention that on here yet. It stimulates the bone marrow to produce white blood cells. I don't see why it wouldn't be given in this circumstance.

Kate

x

[Cathy]

Hi

I'm sure that Jeni would be able to help although maybe not until Monday now.

I know that Linda, you are on a different chemo regime to Jonathan but I don't believe much would happen to your tumor in a week so I'm sure you don't need to worry about that. Jonathan had a holiday in between his 4th and 5th Folfironox cycles of 2 weeks (so a 4 week gap in all between infusions) which his oncologist suggested to give him a break and certainly the oncologist didn't think anything would happen in the meantime. And it did him the world of good.

Jonathan also has a bone marrow booster injection for 4 days following chemo to help with his immune system. I'll try find out what the name of the drug is although I'm sure others will have a far better memory than me!

Cathy xx

[MSH]

Hi Linda,

I had a similar experience this week. I spiked a couple of temperatures last weekend leading to me spending 5 hours in A&E last Sunday night. At that time my neutrophils were 1.5 and they allowed me home with a little persuasion. I was due to have chemo on Tuesday morning but my neutrophils had dropped to 0.5. They said they would have given it if they'd been above 1.0, which they probably would have been had my chemo been on the Monday as it would have but for the bank holiday.

I don't know that there's anything to be done other then the usual things for a healthy lifestyle. The neutrophils can be stimulated with GCSF but such drugs are very expensive. Are your platelets and haemoglobin OK?

Mark

[LindaH]

Excellent advice as always thank you Kate, Cathy and Mark much appreciated.

Linda x

[karen17]

Hi Linda,

I don't think that a week or two off will make a difference. We have always been told that if we want to have a holiday etc it can all be worked out with time off.

Perhaps you need to ask about the bone marrow stimulating injections ( GCSF ). Bob has had these from the start. I give them into his tummy on the 3rd day following chemo for one week.

Take care

Karen xxx

[MSH]

Just browsing I came across the following protocol for Derby Hospitals:

"For any febrile neutropenia or a 2nd episode of low neutrophils, GCSF secondary

prophylaxis should also be initiated with subsequent cycles (Filgrastim 300

micrograms ONCE daily for 7 days, starting on Day 5)"

http://www.derbyhospitals.nhs.uk/search/?q=folfirinox

It's a pdf file. ANC is absolute neutrophil count, and Filgrastim is a G-CSF.

There's a similar policy at the Royal Surrey.

http://www.royalsurrey.nhs.uk/Default.aspx?DN=48037be2-87fb-4651-9b29-132b5af68e0c

My understanding is the nadir for myelosuppression is around 8 days post treatment.

[LindaH]

MSH wrote :

> Just browsing I came across the following protocol for Derby Hospitals:

>

> "For any febrile neutropenia or a 2nd episode of low neutrophils, GCSF

> secondary

> prophylaxis should also be initiated with subsequent cycles (Filgrastim 300

> micrograms ONCE daily for 7 days, starting on Day 5)"

>

> http://www.derbyhospitals.nhs.uk/search/?q=folfirinox

>

> It's a pdf file. ANC is absolute neutrophil count, and Filgrastim is a

> G-CSF.

>

> There's a similar policy at the Royal Surrey.

>

>

> http://www.royalsurrey.nhs.uk/Default.aspx?DN=48037be2-87fb-4651-9b29-132b5af68e0c

>

> My understanding is the nadir for myelosuppression is around 8 days post

> treatment.

That's excellent, thank you very much ....Linda

[Cathy]

Hi

We are only given injections for 4 days. I'll have to ask the oncologist tomorrow why that is... presumably in our hospital that is standard practice.

Poor Jonathan now has to have a daily anti coagulant injection as well so if 4 days in enough then good!

Cathy x

[J_T]

We don't get any!???

[Cathy]

Hi Julia

I would ask? I think it is standard treatment with FOLFIRONOX but maybe as Ray has only just started they don't think it so necessary?

There is a bit on the website here under "side effects"

http://www.pancreaticcancer.org.uk/information-and-support/treatment/chemotherapy/main-drugs-for-pancreatic-cancer/folfirinox

Cathy xx

[KATB]

I was surprised mum - maybe they only give it if low counts start to delay treatment?

K

x