Delayed 2nd FCR 🙄

Well I was mentally prepared for my 2nd FCR on May 8th but not physically it seems. I had my blood tests today and my WBC was down from 149 to 1.9, fantastic! But my neutrophils are also 1 so I can't have it. I'd be really grateful for some neutrophils info as I'm fairly ignorant in this area. Should I worry? I'm back to feeling really tired all the time and I had a chest X-ray today because I feel abit chesty.

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  • Delays in treatment happen so don't worry but with low neutrophils you need to take extra care with infections and what you eat. Read up about diet when you have low figures. No eggs or seafood or even raw veg I think. Keep a close eye on your temperature as low neutrophils is a concern. Time to wrap yourself up in cotton wool as the saying goes.

    However I'm a bit confused because when the Chemo nurse phoned me after bloods were taken to say my neutrophils dipped below 1 they suggested a delay in treatment until they went to 1 or above. This the neutrophils did in 2 days. So are they taking bloods again before the 8th to see if they can continue? I always saw the consultant the day before treatment not the week before like you.

    But every hospital is slightly different in process.

    Take care and soon you'll be back on track and heading towards remission.

  • Hi, yes I am going back on Monday for blood test. In a previous post I wrote how my consultant hadn't wanted to give me rituximab until I had had one lot of chemo because my count was high, but she was told it wasn't trial protocol. I saw a different doctor today and he said she should have contacted trial people and told them they needed to slightly amend procedure for me. I don't know how right that is. I will be extra careful and hopefully everything go well next week!

  • Hi Sally,

    Wait until Monday to see what your results are. If neutrophils are still low then your med team may discuss G-CSF. Lots of previous posts. Try putting G-CSF into the "Search CLL Support Association" box above. Also repeat with GCSF. You can also try Google etc.

    Best wishes,

    Ernest

  • Thanks Ernest yes I will do that

  • Great that you are mentally ready; if you aren't physically ready within a reasonable amount of time, your neutrophils (the main component of our bacterial infection fighting white blood cells) can be boosted by G-CSF (neulasta, neupogen/filgrastim, etc).

    The general rule for what to do for various ranges in the Absolute Neutrophil Count (ANC) from Dr Susan Leclair is:

    1. Greater than 2.0. -- You probably have enough neutrophils to ward off most infectious agents.

    2. Between 1.0 and 2.0. -- You are at some risk for infections that would be difficult to fight off. Start more hand washing, stay away from anyone with a cough, recent immunization with live virus, children, large crowds, etc.

    3. Less than 1.0. -- You are serious at risk. You can eat nothing that cannot be cooked to 165*F.

    No crowds of any sort. Use of a mask if necessary. This is called a neutropenic lifestyle.

    This pinned post contains tips on what not to eat, etc: healthunlocked.com/cllsuppo...

    Stay safe!

    Neil

  • Thank you again, the list of foods is invaluable I had no idea and what I find annoying is that neither my consultant or nurse said I should be careful of what I eat. They did say any start of cough cold or feeling unwell to go to casualty.

  • Don't worry. It is the idea of FCR to minimize the bad cells as much as possible. Bad cells are all Leucocytes, mainly B-cells. Therefore it is good, if Leucocytes come down, consequently also the Granulocytes. My counts went down to Leuco 0,5 and Granu 0.05.

    But it always came back quickly, twice using G/CSF, but that was little painful in my dorsum.

    Two times the cycles had to be postponed for reasons of too low counts, but it didn't bather the treatment. Therefore, keep calm and try to avoid infections.

  • Thank you for your good advice I was just panicking abit!

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