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What is the neutrophil number that everyone's oncologist required for chemo

hopeful girl 1
Posts: 454
Joined: May 2010

Hi all.

I am curious what neutrophil number everyone's oncologist requires to do chemo-I am on taxol/carbo.

My oncologist requires only 1.0---this is quite low as normal range is 2-7.
Last chemo I dropped 1.3 on neutrophils so if you start out at 1 you have nowhere to fall but zero.

I look forward to responses.

Hugs to all!

upsofloating's picture
upsofloating
Posts: 473
Joined: Dec 2009

My gyn-onc requires 1.5 -- no go if lower, but i am in treatment for a recurrence, not first-line carbo-taxol.

lindaprocopio's picture
lindaprocopio
Posts: 2022
Joined: Oct 2008

My oncologist said he'd only allow chemo at 1.3 (my current nuetrofil number as of yesterday's labs) if we were trying to get in the last chemo infusion in a set series of rounds (like the 6th round of carbo/taxol), and he would follow that infusion with a Nuelasta shot the next day and probably give the chemo dose at 80% strength.

With my recurrence, he pushes for 1.5 and would likely delay treatment for a week at 1.3. Did you see my post from yesterday? There may be other indicators from your labs that show your bone marrow is about to recover. But ask about getting Nuelasta or Nuepogen following your next chemo if you're going to get it with nuetrofils so low. I have chemo again next Thursday, and even though my oncologist expects my Nuetrofils to come up from the 1.3 by then, I already have a Nuelasta shot scheduled for the day after. You can't let your nuetrofils hit 0.0 or the Nuelasta has nothing to work with.

Some oncologists don't like Nuelasta because of the insane cost of it and the severe bone pain some people get. But I didn't get bone pain when I had Nuelasta before, and I had 51 Nuepogen shots already with absolutley no bone pain. Could the doctor be having trouble getting the Nuelasta pre-certified with your insurance?

hopeful girl 1
Posts: 454
Joined: May 2010

Linda,

I did see your intersting post about the MONO and the bone marrow recovery.

I checked my test results from Tuesday and mine is at 10. That is the highest end of normal on the chart I have from my oncologist. My chart shows normal numbers are 0-10 for MONO. So hopefully 10 means getting close to recovery.

I have a feeling my oncologist does not like Neulasta for some reason.....the insurance should not be an issue-my coverage has been very good. And with all of the costs for my two surgeries, chemo, radiation, etc....the shots don't seem to be much of a difference at this point....Aren't they around $7K? Severe bone pain does not sound like much fun, I am glad your experience with the shots has been good.

I didn't realize though that if you go to zero the shots have nothing to work with.
That's scarey.

I told my oncologist I worry about infection and he always says don't worry you won't get an infection. But I know with low counts, or zero you are at super high risk for many kinds of infection.

I am scared that when I do finally get the 5th chemo, that my counts will go even lower.

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