Grastofil shots

[Estate1]

Had my first of three Grastofil shots yesterday and curious if anyone else has had the severe low back pain I am experiencing on it. I’m taking Tylenol to help with that nasty side effect.

[cllady01 Former Volunteer]

Below is the mfg. drug sheet with side effects and instructions.

Call your Dr. it may be that your uric acid levels have increased, thus kidney situation could be the problem. Don't delay. Call now and get the Dr. alerted at least.

bccancer.bc.ca/drug-databas...

[Cindi73]

Hi Estate1, I remember when my neutrophils were 0. I had terrible low back pain n that was before the grastofil injections. Cindi

[Estate1 in reply to Cindi73]

Interesting. My recommendation would be to load Tylenol prior and during the shots. I am using 2 extra strength Tylenol about every 4-5 hours. I will keep that up past third shot tomorrow. It’s doing the trick.

[Jemorgen]

What’s grastofil and when do people get it please?

[Estate1 in reply to Jemorgen]

Shots that promote the production of white blood cells. After my chemo sessions my WBC and my Neutrophils were at “critically low” levels.

[Jemorgen in reply to Estate1]

Thanks!

[AussieNeil Administrator in reply to Jemorgen]

Grastofil/Filgrastim, Neupogen/Neulasta and similar are used to boost neutrophil production if we become dangerously neutropenic. Neutrophils are the white blood cells that keep us safe from bacterial infections and in a healthy person, the white blood cell count is roughly 65% neutrophils. Technically these drugs are synthetic versions of the Granulocyte-Colony Stimulating Factor (G-CSF) that our bodies produce to stimulate our neutrophil producing stem cells in our bone marrow. G-CSF injections may be needed during treatment so that treatment can continue, because pretty well all CLL treatment drugs can cause neutropenia. Sometimes CLL bone marrow infiltration during watch and wait can cause neutropenia and neutropenia can also spontaneously occur up to a year after the end of treatment with FCR or BR (R = Rituximab) or for that matter, any other CD20 monoclonal antibody like Gazyva/Obinutuzumab. Neutrophils have a short life span and only last upwards of a few days in the blood. If your bone marrow stops producing them, it takes about 10 days for new neutrophils to be made, during which time you need to be very careful to avoid bacterial infections, avoiding close contact with others, being very careful what you eat, keeping an eye on your skin for any cuts and grazes, insect bites, etc that could become infected.

G-CSF injections are typically (self) administered into the skin above the abdomen through a very fine needle about 12mm/half an inch long, though they can also be injected into the thigh. The most commonly reported side effect is bone pain.

[Jemorgen in reply to AussieNeil]

Will everyone who gets treatment need this?

[AussieNeil Administrator in reply to Jemorgen]

No. With the chemoimmunotherapy treatments like FCR and BR, G-CSF injections tend to be administered if the neutrophil count drops below 1.0 and doesn't recover in time for the next treatment cycle. Sometimes delaying the next cycle is all that is needed.

G-CSF use with the targeted therapies is less often required and the degree of use depends on the drug (and patient). G-CSF injections are more likely needed early on, when the bone marrow can be doubly hit by high CLL infiltration and suppression by the treatment drug(s).

[Jemorgen]

Thanks Neil. So much to learn