Late onset neutropenia from Rituxan therapy

Hello everyone. I'm wondering if anyone here has had any experience with late onset neutropenia. My husband was hospitalised for 10 days, 8 weeks after completion of chemo for follicular lymphoma, with febrile neutropenia. (fevers and extreme night sweats.) He had been declared in full remission having had a PET scan only two weeks before he became symptomatic. They found no apparent cause. Everything came up negative except for severely low WBC. A bone marrow biopsy was done. The initital result showed no sign of lymphoma. Still waiting for final result, something about chromosomes? They gave him a immunoglobulin infusion while hospitalized and sent him home after 24 hours of normal temp. He will have new blood work today and see his oncologist on Wednesday. They are thinking this is LON. They are talking about giving him some type of injections twice a week to boost WBC.

Right now he is feeling good but I'm frightened about this low WBC. I'm keeping him pretty much in a bubble until we see the doctor on Wednesday. If anyone has had experience with anything like this I'd so appreciate your input! 

Comments

  • Max Former Hodgkins Stage 3
    Max Former Hodgkins Stage 3 Member Posts: 3,721 Member
    Shots

    Ret, has your husband received Neulasta or other WBC colony boosters in the past ?  These are given via injection and it sounds like what the doctors are planning.

    Usually, these are very effective and short-term at least will fix low WBC issues.  Bone pain is common however, since the drug radically stimulates stem cell production of WBCs in the marrow.

  • Ret4
    Ret4 Member Posts: 15

    Shots

    Ret, has your husband received Neulasta or other WBC colony boosters in the past ?  These are given via injection and it sounds like what the doctors are planning.

    Usually, these are very effective and short-term at least will fix low WBC issues.  Bone pain is common however, since the drug radically stimulates stem cell production of WBCs in the marrow.

    Hi Max! Yes, He was given

    Hi Max! Yes, He was given Neulasta day after each chemo treatment so he's familiar with that. He takes Claritan and that helps with the bone pain. His WBC was always fine until 7-8 weeks out after chemo. 

     

  • Max Former Hodgkins Stage 3
    Max Former Hodgkins Stage 3 Member Posts: 3,721 Member
    Ret4 said:

    Hi Max! Yes, He was given

    Hi Max! Yes, He was given Neulasta day after each chemo treatment so he's familiar with that. He takes Claritan and that helps with the bone pain. His WBC was always fine until 7-8 weeks out after chemo. 

     

    Odd

    That is odd, Ret, which probably means "not good."  His oncologist definitely needs to figure it out.

    Two years after CR/NED, I becaue seriously anemic out of nowhere (hemoglobin/RBCs), and had to go on IV iron. 

    My oncologist ran a lot of tests, but the cause could never be found. Later, he admitted that the anemia flagged him into thinking relapse, but he never mentioned that as a possibility initially. 

    Eventually, my RBC count evolved back into normal ranges, and anemia never reoccured.  Always something to be worried about ! 

    Good luck with the investigation,

    max

  • skaterdad
    skaterdad Member Posts: 16
    I've heard of it but never had it

    I received Rituxan as part of R-CHOP and my doctor warned me about the possiblity of late onset neutropenia. Apparently it is quite rare (my doctor has only seen a few cases of it), but not unheard of.