Neulasta effect -wbc and ldh up too high

[writepa]

Hi, Just wonder if anyone has WBC shoot up after Neulasta. 3 days after chemo and Neulasta shot, Wbc was still at 1.6 and normal LDH. But 10 days after Neulasta shot, wbc shoot up to 50 level and LDH to 1600, which are both too high

Just wonder if anyone has the same experience. Doctor said might be from Neulasta but he was fine with the last Neulasta ahot. This is the second Neulasta shot after 2nd chemo.

[AussieNeil Administrator]

I don't recall anyone mentioning their LDH going high after G-CSF injections, but it is known to occur:

pubmed.ncbi.nlm.nih.gov/754...

I expect that if you check your WBC, the reason for the big jump to 50 (and I presume that is an absolute count, not a percentage), is due to your neutrophils responding extremely well to the G-CSF injections. (Keep in mind too, that this community doesn't have many with MCL, so we collectively lack familiarity with the differences between MCL and CLL presentation and response to drugs.)

Neil

[writepa in reply to AussieNeil]

Thanks Neil for your response. Yes, you are right, Neutrophil absolute count jumped from 1.4 to 29.7 in a week. I saw leukocytosis is one serious side effect of Neulasta but it's rare and occur in less than 1% of the patients. I hope it's due to Neulasta but not recurring lymphoma or leukemia.

But wonder if it will resolve by itself? And also wonder why the number did not jump in 4 days after taking Neulasta shot but only after 10 days instead.

[AussieNeil Administrator in reply to writepa]

If your bone marrow has stopped making neutrophils, it takes 10 days from when G-CSF encourages your bone marrow to restart making neutrophils until they appear in your blood. I expect your counts will gradually resolve.

[Canuck901]

What is the difference between Neulasta shot and G-csf shot ?

[writepa in reply to Canuck901]

They are basically the same.

G-CSF is another name for pegfilgrastim. In some cases, health care professionals may use the trade name neulasta or other names G-CSF when referring to the generic drug name pegfilgrastim.

[Canuck901 in reply to writepa]

Thanks for the explanation , glad to hear it gave your neutrophils a boost!

Did you fell any different after the shot from days after to 10 days after ?

[writepa in reply to Canuck901]

my husband had some bone pain in the lower back a week after the shot with light fever for two days, about 37.8 oC

[Big_Dee]

Hello writepa

M-m-m... Can't say my WBC shot after Neulasta shot after B+R. Did you have Neulasta after first round of chemo or later rounds. I had my first Neulasta shot after 2nd round of chemo. Blessings.

[writepa in reply to Big_Dee]

My husband had it after each round of chemo. The first shot was okay. This happened in the second time.

[Big_Dee in reply to writepa]

Hello writepa

My jumped around a bit from a low of 3.6K at end of 6 months treatment. My WBC did jump up and down some to a high of 13K. I had neulasta shots after courses 2 through 6. My WBC is now 6.8K 1 1/2 years after treatment. Hope this provides you some info.

[writepa in reply to Big_Dee]

thank you for your information