Docetaxel induced febrile neutropenia

[Jay-kud8]

Just sharing my experience.

Following 1st cycle of Docetaxel on 16th Jan 2023, I had an episode of febrile neutropenia (Neutrophil count: 0.07 X 10^9/L) on 25Jan 2023 needing hospital admission and IV antibiotics. I was poorly for 24 hours.

Oral ulcers which I had are said to be almost diagnostic of neutropenia.

Fever of 38.4

I understand G-CSF Injections do not work well in established neutropenia but are good for prophylaxis

I probably over did the exercise bit in the days following the chemo. I have learnt this has to be in moderation. Did not rest when I felt a bit off on days 6,7,8 following the chemo.

The counts have come back to normal and I am feeling fine. I am having the second cycle tomorrow.

I am prepared with Caphasol mouth wash, Difflam mouth spray, Vaseline for nasal mucosa G-CSF prophylaxis.

I will take it easy especially around the second week following the chemo, hopefully it will all be uneventful.

[Tall_Allen]

You may find that Claritin or similar antihistamine may prevent a histamine reaction to G-CSF.

[Jay-kud8 in reply to Tall_Allen]

Thank you, I have that ready. Anti sickness tablets were not needed last time. I will refrain from taking Paracetamol or NSAIDs for minor aches and pains in case it masks the fever , which I have to watch out for.

[OzzieJ]

I'm just ahead of you on cycle four. I'm taking a neulasta injection the day afterwards which helps with white blood cells. I was also exercising normally for the first few cycles. But now the fatigue is a bit worse so taking it a bit easier. In particular was completely wiped for the first 5 days after this last cycle. You might also find the fatigue starts to add up.

All the best.

[Jay-kud8 in reply to OzzieJ]

Thank you. I will moderate the exercises.

Good to hear you are keeping up with your skiing through chemo.

[rsgdmd]

I didn't anything after my 1st round of chemo and ended up severely neutropenic, with WBC of 0.8 and neutrophils of 0.1. Fortunately, I didn't get sick. Got Ziextenzo (bio-equivelent to Neulasta) after the rest. Worked fine, except after the last round, when, at one week, my WBC was 3.1. It's 3 mo. later & that's the highest it's been. Been floating between 2 and 2.8.

[Jay-kud8 in reply to rsgdmd]

Thank you. Is it just your WBC count that is suppressed or other counts like platelets and RBC also suppressed?

Wishing all the best with your treatment.

[rsgdmd]

Others are a bit low, likely from ADT, but have come up a bit. May need a bone marrow biopsy if doesn't improve. Thanks

[Grateful4this]

When it comes to exercise during the treatment cycle I tried to listen to what my body was telling me. If I was tired I rested but if I wasn't feeling tired or ill, I would try to do some activity as it helped both my physical and mental state, believing this a way to fight back. As I progressed in my treatments fatigue became more of a factor but it does get better when you are finished.

[Jay-kud8 in reply to Grateful4this]

Thnk you. I will listen to my body and moderate the exercises.