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Had my 'between chemos' NADIR lab work done today & learned something I wanted to share.

lindaprocopio's picture
Posts: 2022
Joined: Oct 2008

I'm getting Doxil 28 days apart and my oncologist is planning on drawing labs midway between my infusions as well as 'chemo days', so that he can see how I'm doing at my lowest point, my 'nadir'. Today I had my 1st 'between chemos' lab work done, a little late since he was off last week. My platelets were good and RBC only a little low, but my white count was off enough that he said if this was a chemo day I wouldn't be getting my infusion. He looks at Neutrofils as the real indicator of my immunity, and they were 1.3 today. He will allow chemo with Nuetrofils as low as 1.5 which is still really low. But when I asked about getting a few Nuepogen shots between now and my scheduled Doxil infusion next Thursday, he said that wouldn't be necessary. He said "Look at your Monocytes number; look how high that is. (It was 13). He said "An elevated monocyte number shows me that your bone marrow is entering recovery and that in 3 or 4 days your nuetrofils and white count will both be up. You'll be fine for chemo next week."

Soooo, what I learned is the significance of monocytes (Indicted as MONO on your labs). I learned something new, and now so did you! :D

He did schedule a Nuelasta shot for me for the day after my next chemo, since he now knows I will have WBC struggles with this chemo drug and will want to stay ahead of that. I LOVE Doxil as far as how WONDERFUL I feel and how much energy I have and my eyelashes and brows are back. I sure hope it's working because this is an easy chemo to take for me so far.

They drew blood for a CA125 but by the time I remembered to phone and get it, the oncology nurse had left for the day. CA125 is irrelevant this early in the game, as Doxil is famous for raising CA125 for the 1st couple of infusions. But curious minds need to know... I'll call again tomorrow.

Kaleena's picture
Posts: 2064
Joined: Nov 2009


As always, thank you so much for sharing all of your input. It is always good to learn something new. I am glad that you are feeling wonderful and have a lot of energy.


Ro10's picture
Posts: 1579
Joined: Jan 2009

Linda I am so happy you are tolerating the Doxil, so well. I hope it is doing its job to kill all those cancer cells. After all your weekly treatments, the every 28 days probably seems like a big break for you. Glad your platelets and RBC's are holding up. Hopefully the Neulasta will help the WBC.

Thanks for sharing the above info. You are always educating us. So glad you are able to enjoy things and people in your life. In peace and caring.

hopeful girl 1
Posts: 454
Joined: May 2010


Glad you are finding the Doxil easier.

I found it interesting what you wrote. I had an additional question about the neutrophils.

I am on taxol/carbo and have two more chemos to go. I am delayed on my 5th chemo right now for platelet count which is 69,000. My oncologist will not do chemo under 100,000.

I will check my mono count on the results.

However, my oncologist will do chemo if neutrophils are 1.0 (which is actually quite low).

When you had your taxol/carbo, what neutrophil number would your oncologist do chemo with? Was it the same as for Doxil?

Also, my oncologist does not seem to use those booster shots.

Thank you and please advise.


lindaprocopio's picture
Posts: 2022
Joined: Oct 2008

I had a week's delay and a blood transfusion for platelet and RBC problems for my 4th and 5th rounds of carbo/taxol. For my final round of carbo/taxol I had 10 days of delay, a blood transfusion before my chemo, got my chemo at only 80% strength, and had to get a Nuelasta shot the day after my last infusion and a blood transfusion later that final week. Carbo/taxol is a ROUGH chemo combo!

I can't remember my actual counts, but I know they were always low and without all of this blood/time/shots intervention, I wouldn't have been able to finish my 6 rounds. I know my counts were low enough that I felt 'wifty' all of the time and didn't drive a car because I knew I wasn't a safe driver. I wore a face mask when I went grocery shopping because my WBC was so low. And I remember being able to feel my heart just from climbing the stairs, and how scary that was. And yet we pushed on with the chemo. My oncologist was determined to cure me if he could; and I was the kind that cried when I was told I couldn't get chemo that day and tried to talk him into it. He used to say to me all the time "We're trying to kill your cancer, Linda, not kill you", as he sent me home to wait another week for my treatment.

Now, after a recurrence, quality of life and protecting your bone marrow for the long haul is much more of a consideration. You have to be as aggressive as your body can handle when you're shooting for a cure, with the hope that you'll have the rest of your chemo-free life to recover. Once a cure is no longer an option, then it's a careful balance to protect your bone marrow because chemo will most likely be a part of your life off and on for years. But for now, GO FOR THE CURE!!

hopeful girl 1
Posts: 454
Joined: May 2010


If I am understanding you correctly the neutrophil count of 1.5 that you must be at to receive the doxil chemo is a higher number than what your oncologist required you to be at for carbo/taxol? Do you have the same oncologist for doxil as you did for taxol/carbo?

Does 1.0 for neutrophils to as the minimum number to receive chemo sound ok to you? I guess it is lower because going for the cure on the carbo/taxol treatments? More agressive than if/when a reoccurence happens.

I was sent home on my scheduled 5th chemo appointment, and a week later (which was two days ago) because of platelets. My oncologist does not give a transfusion for hemaglobin until 7 or 8, I am at 9 (which I know is low). Even though I am low on platelets, I understand you have to be around 20,000 to get a transfusion for some reason and I am at 68,000. The WBC I am at 2.0 and neutrophils 1.5--------------still low but that was not the reason for no chemo.

I am scared because I want my neutrophils to be above 2 when I am able to get the 5th chemo-hopefully it will be since I have to wait at least another week, because I don't think my oncologist likes to use those booster shots-I will have to ask about that. I was told by his nurse that even if you drop to zero, they won't do anything......

My medical team is at a well known university hospital and my oncologist is so popular he is double booked for each appt. But I notice that practically everyone here has had these shots for white counts etc so I am concerned that it seems my team does not use.

I am worried, since I am now off schedule, how this will affect my cancer marker number. I am at 5 right now and have been since after radiation, and my 4th chemo. I hope the number does not go back up since I am behind schedule. I was stage 3C.

I am so glad to hear that you are feeling vibrant and well. That is wonderful!!

I saw in another post that you have practiced yoga for years-that is great.


TiggersDoBounce's picture
Posts: 413
Joined: Oct 2009

Thanks as always for sharing :)

Hope you enjoy the weekend!! Stay Well!


Songflower's picture
Posts: 631
Joined: Apr 2009

I am on doxil again with you. I take it every 21 days with avastin. It makes me very sleepy the first week (but that may be the avastin) and she gives me neulasta. What dose are you getting every 28 days? I think I have to take it every 21 because of the avastin. I too think it is easy to take except when I got the rash. I am trying to do the cooling for five days and not slack off!


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