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Neulasta shots and chemo

mariam_11_09's picture
Posts: 695
Joined: Nov 2009

I had an appointment with the RN yesterday to go over the chemo schedule, side effects etc and set the start date which is in exactly two weeks. I am doing 4 rounds of AC. However I was told that the oncologist had put in that I was to have the neulasta shot the day following chemo. I was quite surprised and the RN couldn't tell me why, she didn't know. I thought that this was only given if your white blood count was low. I know I am a little anemic. My white blood count appears to be within normal limits and when I had that blood test 6 weeks ago I had a horrible cold. In addition I did have a little infection right after my surgery and I am not fully healed from the breast reconstruction. Perhaps that is a part of the reason.

I do have an appointment with the Oncologist before I start the chemo so I can ask him for the reason. However I am curious to know if anyone else had to have the neulasta from the first chemo.

Posts: 66
Joined: Dec 2009

Yes, I just finished my fourth round of A/C and I had the neulasta shot the day after each one. It is to boost your white blood counts and also helps your bone marrow the way I understand.

aztec45's picture
Posts: 757
Joined: Jul 2009

I think the doctors already know from past experience that more than likely, your white blood cells will drop and so they will be prepared and give you the shot. I had six rounds of chemo and had the shot after chemo each time. I took claritin to help offset the muscle aches.

Good luck,


Sher43009's picture
Posts: 602
Joined: Nov 2009

On average it takes 3 weeks for your blood cells to come back up without neulasta. If you are having chemo every 2 weeks you need the neulasta shot to boost your blood cells.

DebbyM's picture
Posts: 3293
Joined: Oct 2009

Sending you good luck and support!

Hugs, Debby

CR1954's picture
Posts: 1393
Joined: Jul 2008


I had a Neulasta shot every time I had chemo, and my blood count stayed within normal range.
My oncologist is also a hematologist, so I trusted his judgement, as far as the shots went. Even though I sometimes had some bone pain from them, as long as he felt I should have the injections, I did.


Skeezie's picture
Posts: 586
Joined: Aug 2009

I am shocked the chemo nurse didn't know what Neulasta is. That is standard operating procedure when getting chemo. It keeps the white blood cell count up so they don't have to stop chemo while the blood builds itself back up after each chemo infusion. I didn't go back to the onc for the shot, I have an RN next door and she gave it to me. Or else my husband would have done it. Saves a trip back to the doc's.

Don't be afraid to call your onc to ask about this or any other question you have about anything, anytime. Obviously that nurse needs some additional training.

Judy :-)

dyaneb123's picture
Posts: 951
Joined: May 2009

Your blood count will drop drastically right after the chemo, so even if it is normal now, it probably wont be after treatment. You are too open to catching things when it is so low, so you must have the booster.

Marlene_K's picture
Posts: 508
Joined: Jul 2009

I had TAC (Taxotere, Adriamycin & Cytoxan) every 3 weeks for 6 sessions. I had the Neulasta shot every time the day after chemo since my first treatment. My oncologist doesn't give a choice. My blood counts were always perfect and I never got sick... with my boys bringing home coughs, sore throats & colds, I think that was a real good thing.

What is your concern over having it? As far as I know, there is no danger... unless you know something I don't know. Mar

Posts: 34
Joined: Dec 2009

Mariam, The first chemo treatment I took (taking 4-3wks apart) my Oncologist decided to see if I could get by without having to take the Neulasta shot to keep my blood counts right. But.... 5 days later when I went back for a check, he found I was getting in trouble with my counts, so I had to take the Neulasta. So next time around, I got the chemo one day and 24 hrs. later I got the Neulasta shot, which I hate so badly, but know it's necessary. I feel horrible for about 4-5 days follwing that shot. But I will be going for my third treatment the 17th. and the doctor told my daughter (who is an R.N. at the Cancer Center I go to) that this time they will give me Claritin before the injection. This is supposed to help with all the problems I have following that shot. But yes, that is the norm I guess, that we have to have the Neulasta shot 24 hrs. after chemo. Best wishes. I'm sure you will do well.

Posts: 3600
Joined: Aug 2009

When I was on A/C I got Neulasta the next day. The only SE I had from it was exactly 2 hrs after the shot I was ready for "nighty - nighty" for a few hours. Blood work great before ataarting and stayed great during the time of A/C and Neulasta. Taxol was another story though as far as anemia (never been anemic til on it and still am since the last of it but am coming back up slowly.

chipoo's picture
Posts: 32
Joined: Nov 2009

I give myself the Neulasta shot the day after each Chemo. treatment. I have my 6th and last treatment coming up next Friday. It is standard practice where I get my treatment. I am fortunate that I have not had any side effects from the shot.

Posts: 598
Joined: Sep 2009

I was told that you recieve the shot after AC, so I wouldn't "bottom" out my WBC's. It calls the immature wbcs out to get busy growing cause the older ones are dying off! Sounded weird to me, but I never dipped below normal, so I guess they were right. lol

VickiSam's picture
Posts: 9054
Joined: Aug 2009

my 'big' TCH treatment 5 to 6 hours of drip .. 24 hours later a neulasta shot .. believe me when I say .. our body needs this shot.

KUDOS to all of you women who did 'not' have any side effort from the neulasta shot .. ask your oncologist about neulasta - side efforts ..

Good Luck,


mariam_11_09's picture
Posts: 695
Joined: Nov 2009

Thanks everybody for you input. I understood from the RN that the neulasta was only given when your blood count hit a low, that is why she had said to me that she didn't know why I was being given it starting after the first chemo. However from all your wonderful input it seems like it is par for the course.

thanks again.

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