About Kirsten Sizer Expertise I can answer basic questions regarding haematology. Blood coagulation, blood-borne diseases, blood typing, platelets, abnormalities within levels in the blood, any question you feel is too daft to ask, please feel free to ask.
Experience Studied haematology as part of my degree
My mother is receiving chemotherapy for colon cancer, her doctor prescribed neupogen after each cycle because she had low WBC counts. She gets 3 shots in the 3 days after treatment and her counts reach about 12.000 .but after two weeks when its time for the next cycle the counts fall again and they say that they have to delay it for another week.
1) what would be the solution for this problem ? could another 2 shots of neupogen in the 2nd week help?
2)does neupogen affect platlet count because she has been having thrombocytopenia since the 8th cycle.
thank you
Answer Hi, Neupogen acts as a granulocyte-colony-stimulating factor and is known to cause thrombocytopenia. Basically neupogen can enhance the phagocytic ('cell eating') activities of neutrophilic leukocytes (white blood cells), including activity directed at autologous platelets. Neupogen can stimulate white blood cells to the point that they can attack the platelets in the blood, causing the low platelet count.
It may be worth seeing if she can get more, lower dose shots more often, so not increasing the amount of neupogen overall but spreading out the dose so your mother can maintain a healthy level of white blood cells.
The recommended starting dose of Neupogen is 5 mcg/kg/day‚ administered as a single daily injection by SC bolus injection, by short IV infusion (15 to 30 minutes)‚ or by continuous SC or continuous IV infusion. A CBC and platelet count should be obtained before instituting Neupogen therapy‚ and monitored twice weekly during therapy. Doses may be increased in increments of 5 mcg/kg for each chemotherapy cycle‚ according to the duration and severity of the ANC nadir.
Neupogen should be administered no earlier than 24 hours after the administration of cytotoxic chemotherapy. Neupogen should not be administered in the period 24 hours before the administration of chemotherapy. Neupogen should be administered daily for up to 2 weeks‚ until the ANC has reached 10‚000/mm3 following the expected chemotherapy-induced neutrophil nadir. The duration of Neupogen therapy needed to attenuate chemotherapy-induced neutropenia may be dependent on the myelosuppressive potential of the chemotherapy regimen employed.
I have found a paper that is very relevant to your question, as well as the information sheet for Neupogen. I have attached the link below.
