Low white blood cells

[Tulips66]

Hi ladies, I have just recently started chemo again for first recurrence high grade serous OC & am on carboplatin /Gemcitabine one week & two weeks later just Gemcitabine on its own. In 2019 I was on carboplatin /taxol & had no problems but this time it hasn't started well as 2 weeks ago white blood cells were low but OK enough to get the Gemcitabine & this week they were so low I couldn't have the chemo & I was really disappointed & upset. They hope my blood cells will come back up & try again in two weeks time or I might need injections to help boost them. I did have my first covid vaccine a few weeks ago, not sure if that's anything to do with them been so low, but just wondering has anyone had this problem with this regime?

[SASSY196]

Hi, I'm similar in that with injections managed first line mainly ok, although had a blip at one point, but I have just started carbo/ caeylx and even with injections it was too low on wed to have even 2nd chemo even after one dose. When I checked on forum I saw chemo going ahead at different neutrophil levels. I was back at hospital yesterday for retest of blood and chemo could go ahead and asked nurses about variations between hospitals. They said it wasn't variations between hospitals but variations between chemos, so the threshold varies depending on chemo you are on- my current chemo is 1.5 threshold.It may therefore be that the threshold is higher for your current regime than the previous, may be ask for details? What were you measuring and were you offered injections ?

If not 2 weeks seems quite a.long time to wait if they could boost you in couple of days and if the shortfall wasn't much why not try earlier blood test ( I was 1.39 on Wednesday but 2 yesterday without injection so you can change quickly).

I suppose the key thing you/I need to know is if delaying treatment changes outcomes, if it doesn't then I will just accept it but if it does I will be arguing for notes injections/ earlier retest etc. Not sure how vaccine contributes.

[Tulips66 in reply to SASSY196]

Hi Sassy, thanks for replying. I think the nurse said they were 0.8 & she said that my oncologist will decide on Monday when they have their multi disciplinary meeting whether I need some Neulasta injections to boost the cells. I am feeling OK just very tired & frustrated that I have only had 2 days of infusions so far & have problems already. Hope you are doing OK & will get through your chemo without anymore blips. Take care & let me know how your doing X

[SASSY196 in reply to Tulips66]

You too, we are similar age- I am 55 in June and was also 53 at diagnosis. Ran ( (well walked mainly) Great North Run as not feeling well and told probably had oc next day. Anyway best wishes xxx

[Tulips66 in reply to SASSY196]

Yes Sassy I am 55 too & like you shocked when diagnosed as no symptoms until 3 weeks beforehand & no history of any cancer in my family. All the best X

[Gemimablackvelvet in reply to SASSY196]

I Completely agree with Sassy on this one.

[Cumbrianlass5]

My hospital gave me injections to give myself in my belly for a few days after every chemo session (carbo/taxol). They were to help with levels. Hope you are getting those. All best wishes x

[Tulips66 in reply to Cumbrianlass5]

Hi fair play to you for injecting yourself, I don't think I will be able to do it myself but my hubby will be only too delighted to do it as after my first op, when the nurses were showing him how to give me the clexane injections he rubbed his hands together & joked it was pay back time 😂😉

[Cumbrianlass5 in reply to Tulips66]

LOL! You just do what you have to do. A just think of diabetics who have to inject themselves many times a day x

[Mumsie13]

Hi. I had something similar happen. I had carboplatin again for first recurrence with caelyx so not quite the same but from the beginning I had a problem with low neutrafils as doctors said I'd had an infection. The infusion was delayed by a week. I had to have injections (sorry can't remember name now) to bring them back up. Everything was ok until halfway through treatment when I started getting really awful symptoms and it was discovered my magnesium was extremely low. Ended up in hospital for ten days trying to get my magnesium stabilised (and for another issue as well) only to have my next chemo treatment delayed a week because magnesium had dropped too far again. Had another huge magnesium infusion a had treatment a few days later. I managed to finish treatment with constant magnesium infusions ( and supplements) although they had to reduce the dose of the carboplatin which they said was responsible for the problem. I had carbo/taxol first time round and was fine apart from some neuropathy. I didn't have a problem with the carboplatin, so you never know. What I do know is that few days can make a difference to the neutrafil levels. I usually had my blood tests on the morning of my pre chemo assessment but for some reason I had to have them done three days earlier and my neutrafils were low. Doctor said it might have been because I had had bloods too early and sent me off for another blood test that afternoon but still booked my appointment for chemo as usual. He phoned next day and said all was fine I could go for the treatment, I had just had the blood test too early. I never did have to have the neutrafil injections again for the rest of the treatment. I don't know why I had a problem with carboplatin this time and not the first time- maybe it was the different mix of drugs. who knows. Sorry this has rambled a bit but my point is that I still finished my treatment, albeit a month later than anticipated. I know it's frustrating, believe me, but things will sort themselves out and I'm sure you will get your neutrafil injections if they are going to help. Take care. Jackie 🤗

[SASSY196 in reply to Mumsie13]

Thank you that's helpful for me to know as well as Tulip as I am on carbo/ caylix. I will try to have lots of Epsom salt baths re magnesium however I think if things drop in a big way infusions / injectionsare unavoidable . Hope you are doing well xxx

[Tulips66 in reply to Mumsie13]

Thanks so much for replying, you didn't have an easy time of it but it's encouraging to know you still got through it & now I know I will too even if it takes a bit longer. Take care X

[thejoannabell]

I had a similar situation during frontline carbo/taxol. I had to get neupogen injections prior to chemo for a couple of cycles, but it worked. I would like to echo Sassy’s advice to advocate for yourself re: getting treatment sooner if you feel that is what you need.

[Tulips66 in reply to thejoannabell]

Thanks for replying, nurse will let me know tomorrow what oncologist has decided. Hopefully this will be the only hiccup & I will get through the other infusions with no more problems. Take care X

[Leniko]

When on Gem, they sent me home wearing the Neulasta auto-injector on my arm. My WBC stayed within range. 🙏

[Tulips66 in reply to Leniko]

Hi leniko, thanks for replying, hopefully they work for me too, it's hard enough getting through this without having step backs isn't it? All the best X

[Leniko in reply to Tulips66]

It sure is! But we do what we have to do. One day at a time. 🙏

[Ruebacelle]

Demand the booster shots after each chemo Gemzar is very hard on white count

[Tulips66 in reply to Ruebacelle]

Thanks Ruebacelle, it's good to know this is normal when on Gemzar. Oncologist said it wouldn't be as severe as when I was on carboplatin /taxol but so far it doesn't look like that's going to be the case. Take care X

[Ruebacelle]

Gemzar chews up blood cells. You should have booster shots routinely to keep on schedule. Hoosick. Hugs from france altho at the moment am in the usa