Neulasta

 

I've already gotten 1 Neulasta shot the day after chemo and my doctor has me scheduled for a shot this week and a shot next week and then I'm supposed to start chemo again on the 16th. Everything I've read says that you shouldn't take Neulasta within 14 days of starting chemo (and typically it's only given once per cycle), so if I take it what will happen?

Comments

  • Max Former Hodgkins Stage 3
    Max Former Hodgkins Stage 3 Member Posts: 3,819 Member
    Confusion

    What type of chemo are you on, Terry ?   The "cycle" of some combinations is staggered (some drugs one day, other drugs on another), which can complicate things.  I would highly assume that your doctor is correct in what he is doing, but it cannot hurt to ask. Give him a call.

    Also, oncologists are authorized to alter the recommended dose and scheduling of the drugs they use if they feel it will benefit the patient.

     

    I am interested in what your doctor's reply is.

     

    max

  • dcterry1
    dcterry1 Member Posts: 2

    Confusion

    What type of chemo are you on, Terry ?   The "cycle" of some combinations is staggered (some drugs one day, other drugs on another), which can complicate things.  I would highly assume that your doctor is correct in what he is doing, but it cannot hurt to ask. Give him a call.

    Also, oncologists are authorized to alter the recommended dose and scheduling of the drugs they use if they feel it will benefit the patient.

     

    I am interested in what your doctor's reply is.

     

    max

    Oh I'm on R-EPOCH so I do 5

    Oh I'm on R-EPOCH so I do 5 days inpatient chemo, and then I have 16 days at home.

  • Max Former Hodgkins Stage 3
    Max Former Hodgkins Stage 3 Member Posts: 3,819 Member
    dcterry1 said:

    Oh I'm on R-EPOCH so I do 5

    Oh I'm on R-EPOCH so I do 5 days inpatient chemo, and then I have 16 days at home.

    OK

    My next-door neighbor did about six months of R-EPOCH a year before I came down with my own case of lymphoma. He too had to receive it as an impatient, and it was a harsh ride for him, although he was about 35 years old at the time.  HE went from about 300 pounds to around 160, and could not walk for a while at the end. My wife and I had not seen him for about two months, when one morning we saw his room-mate, a weightlifter, carrying him to the car, to go to the hospital for his days on infusion. He was bald, and seemed semi-conscious.

    I do not know what strain of the disease he had, except that it was an aggressive NHL (I asked him, but incredibly, he himself did not know). Since at least ten of the 30 or so types of NHL are "highly aggressive," it is probable his disease strain was different from yours.  His biopsy node, from under his armpit, was baseball sized.  The good news: He has been totally NED ("No evidence of Disease'; cancer-free) for nearly six years now.

    Most of the folks writing here about R-EPOCH describe having had a much easier time than my neighbor did, and I do not think his case was in any way typical.  R-EPOCH is R-CHOP with the drug Etoposide added, so much of your experience sould be similiar to what R-CHOP patients go thorugh. But Etoposide itself is usually regarded as harsh, and it is commonly given to patients prepping for stem cell transplantation, or with serious, advanced disease.

    Again, I would simply ask the doctor or his NP about the scheduling of the Neulasta...the best I can come up with. But again also, I would assume at this point that his scheduling is sound and effective.

     

    The link below on Neulasta differentiates between the "Pegfilgrastim"  form of Neulasta, and the "Filgrastim" form, which it says is an older version.  According to the link, the 14-day wait is only associated with the newer, Pegfilgrastim form, so it may be that you are receiving the Filgrastim ?  I received the older version five years ago, and it kept my WBC counts at or above normal all the way through my six months on R-ABVD.  It is very effective.   Questions only the doc can answer,

    max

     

    R-EPOCH:  http://chemocare.com/chemotherapy/acronyms/epoch-r.aspx

    Neulsata:  http://chemocare.com/chemotherapy/drug-info/Neulasta.aspx

     

    .

     

  • ikelso
    ikelso Member Posts: 1
    Howdy,
     
    I start treatment

    Howdy,

     

    I start treatment tomorrow for classical Hodgkin's with a course of ABVD every 2 weeks.  The day after each infusion I'm scheduled to go back into the office for a Neulasta shot.  These are scheduled to start immediately after the first treatment, no waiting.  I'll end up having it twice per cycle. 

    Can't tell you what will happen since I haven't ever received it, but you should talk to your oncologist's office about it if you don't feel comfortable with the recommendation.  They will likely be able to point you to something they've done/seen that shows it helps to administer it earlier.