white blood cells extremely low even after receiving Neulasta

[Gradees]

Hi everyone.

My dad has PCa that has metastasized to his lungs. He started Jevtana 2 weeks ago and 24 hrs he got the Neulasta. Last Thursday he went for lab work and his white blood cells are extremely low. He says he feels fine and he has hasn’t experienced any pain. But the fact that his blood count is low is alarming to me. The nurse from Duke called to inform him of the lab work and asked how he was feeling. He told her she felt fine. All she said was call triage if you begin to run a fever.

Has anyone else experienced this? What was the outcome?

Any information is appreciated. I feel lost and concerned.

Thanks

Dee

[PCaWarrior]

How low are his counts? Neutrophils?

Did he do the Jevtana on the 5th and Neulasta on the 6th and had bloodwork on the 10th? Timeline is important. Neulasta can take 5-6 days to increase neutrophils and they tend to peak a few days later. WBC nadir is usually 5-7 days after infusion.

Don't freak out. Monitor his temperature but the neutrophil decrease, while serious, is extremely common.

[Gradees in reply to PCaWarrior]

Hi.

Thanks for responding. I apologize I forgot to include the dates.

WBC's 0.9

Absolute Neutrophils 0.2

April 7 Jevtana chemo

April 8 Neulasta

April 17 lab work was done

[PCaWarrior in reply to Gradees]

His risk of infection is rather high. Can he stay home for a week?

I'd rather be safe than sorry. I'd ask anyone who comes over to visit to wear a mask and wash/sterilize their hands. And if someone was sick... Not coming over unless it's life or death.

[Gradees in reply to PCaWarrior]

Yes. I will make sure he stays inside this week. Thank you so very much.

[PCaWarrior]

No need to panic. Just reduce the possibility of infection until his WBC and neutrophils recover. For the blood testing, I wouldn't go to a lab (I'm healthy except for PCa and I don't mess around with labs and hate going to hospitals). I'd get a mobile blood tech. The one I use is about $50 a visit. For me it saves an hour or so and a round trip and avoids the infection risk.

[Gradees in reply to PCaWarrior]

Sounds like a great idea. Thank you so very much!

[LuvLapsang]

I’m also just starting Jevtana, and I experienced a similar WBC collapse (down to 0.69). I was supplemented with a fast-acting booster (assuming it was Neulasta) beginning one week from my first Jevtana dose and sent home with two additional boosters to self-administer. WBCs shot way up, then were roughly normal by the time of my second Jevtana dose. Instead of waiting to see if the WBCs got nuked, I was sent home with a different (time released vs. fast-acting) booster to self-administer the next day. That’s essentially where I stand.

You mentioned your dad hadn’t experienced any side effects from the treatment, which is good. Two days after my initial (Neulasta) dose, I had rather excruciating bone and joint pain. Same after the second Jevtana plus Neulasta. I wasn’t told in advance of the first Neulasta that there could be side effects, but I was warned the second time. The bone and joint pain lasted 4-5 days the first time, and I’m on day 3 of pain the second time. My pain meds may take the edge off, but by no means are they powerful enough to suppress the pain.

I wish your dad the best with his treatment. In the midst of all the issues, I can say I had a 52-point drop in my PSA over the course of two weeks between my first and second Jevtana doses (taken a week after the first dose and on the day of my second dose). That’s what I want the treatment to accomplish, so I suppose I have to live with the side effects.

[Gradees in reply to LuvLapsang]

Those are great results. I really appreciate you responding and I wish you continued successful results with your treatment! You got this!!!!!!!!!!

Dee

[j-o-h-n]

Did you ever discuss "Keytruda" for his lung issue (metastasis)? It worked of me at MSKcc. Ask him and get his response. (Some doctors know their shit and some don't)......

Good Luck, Good Health and Good Humor.

j-o-h-n

[Gradees in reply to j-o-h-n]

Hi John,

I did not. But my sister and I will meet with him this week and ask. When we went for the last appointment we had to see a different doctor because his was out on family emergency.

Thanks for making sure I stay on top of that. Will circle back and let you know what the doc says!!

[Warra]

Sorry to read this. Hope your dad has a catheder. Septic shock is a risc. Without a catheder little chance to find a vein because blood pressure drops too low in case of septic shock. In case of slightest fever rush to the hospital. Wish you and your father the best.

[Gradees in reply to Warra]

Thank you so much.