Fever post chemo

[Marie-54]

I have developed a fever. Round 5 of FCR infusions was Monday, Tuesday and Wednesday. My normal temp is 36.6 and Thursday evening it went up to 37.5 for the first time. Then on Friday it rose all day until it reached 38.12 (Anything over 38C (100.4 for USA) means you have to call it in, so I called the emergency line. They had me come into the hospital right away, where I was isolated from the rest of the population and a ton of tests were run.

Chest xray, urinalysis were both negative. Bloodwork is dropping. I have SLL so my numbers are not like most of you, but my WBC has dropped to 2.5 (should be between 3-5 and 10.5) and is made almost entirely of neuts. No lymphocytes, no monocytes etc. We are still waiting the results of the blood cultures. Because the neuts are above 1, I did not receive gamma globulin, but was given antibiotics and am home watching my temp go up and down like a yoyo. Doctor says I can expect to become neutropenic by the time I reach nadir (14 days after chemo).

It has not gone below 37.3 and has gone as high as 38.35. It is aggravating not knowing what is causing the fever. If there is no infection, what else could it be? Any ideas?

[Cllcanada Top Poster CURE Hero]

Hi Marie

I might suggest you have what is termed febrile neutropenia. It can resolve, but may need a G-CSF, like neupogen, neulasta etc. A count of 1 is low and you need to be cautious of particularly foodborne infections.. maybe skip the salads for a few weeks and used cooked veg... for example, although with a temperature you may not feel much like eating. ☹️

If it is the same tomorrow I would touch base again with your medical people, for an update and advice.

en.m.wikipedia.org/wiki/Feb...

I recently had zero neutrophils and over a few days neupogen injections brought my level of neutrophils within range.

This is not common on FCR, but some patients have this and need it managed.

~chris

[Eric70]

I'm sure it is an infection Marie. this has happened to me 3 times now and they have run every test known to man but nothing shows up. In the end Antibiotics did the trick but it generally takes 4 or 5 days at least. The last infection happened to me 5 months after Chemo, so do take extra care when you treatment has finished.

[MelaniePet]

Hi Marie

This happened to my dad after rounds 5 and 6 of FCR. That was just before Christmas. He’s now fully recovered and doing really well.

They never really got to the bottom of what caused the fevers, but assumed it was an infection of some sort. He also had a ton of tests with no results.

[Marie-54]

Good to know. The good news is that this morning, my temperature has finaly returned to 36.5 which is MY normal. What a relief that the antibiotics seems to be doing the trick. And if I am hearing the messages correctly, I must keep that thermometer at my side and use it regularly even post chemo. 6 months? A year?