Nuepogen vs Neulasta

[Mary4Mike]

I am wondering if anyone has experienced different results using Neulasta vs Neupogen. Mike received Neulasta after each of his last 7 cycles of Dacogen and we never saw much rise in his whites. The doctor just said his counts would have gone even lower without it. They always gave it to him on the Monday or Thursday after the five day cycle. The literature says to have it within 24 hours of your last chemo treatment. He never received it that soon after. When his white kept dropping after this 7th cycle, and after the Neulasta injection, our new doc ordered up 4 neupogen shots and his counts really went up. He was able to begin Dacogen again today, the first time he has ever started treatment on time.

Any input on this would be appreciated.

Mary

[jaxem]

so you’re questioning neupogen vs. neulasta. my wife always reacted positively to either where neulasta lasts much longer than neupogen. it would seem to me giving either within 24 hours of chemo wouldn’t do much as the chemo would swamp it out. normally i thought you would wait 7-10 days after chemo and wait for the whites to rebound, then give it. if you have minimal whites and you try to multiply them, you’re not going to get much replication.

[Mary4Mike]

Jack,

I thought the whole point of taking Neulasta or Neupogen was to build the whites back up so not to experience the neutropenic dangers. When you say to wait for the whites to “rebound”, do you mean the “start” of the increase in whites? I hate to think that those 7 Neulasta shots were washed out by the chemo, but he never showed the kind of response that he got from the Neupogen. Perhaps that is what happened, a wash out. The longest he went between chemo (last day of) and the Neulasta was 6 days. He still didn’t get a response. He finishes cycle 8 of Dacogen on Friday and is scheduled to receive 4 daily Neupogen shots next week. The Neupogen enabled him to stay on schedule for the first time and hopefully it will again for cycle 9.

He has had a mixed response to the Dacogen, however, he says he feels better than when he was just doing transfusions every other week. I do believe, though, that people get used to living with a low HGB.

We have to keep trying. Thanks for your input.

[jaxem]

mary
correct about what both drugs do. it is like doing a multiplication problem. if you have a large amount of whites and multiply it by some number, the product of the number will be large. but if you start with a small number and multiply it, the result won’t be very large. I’m saying most clinicians will wait until the whites start to go up, then give the shot. also some clinicians believe that giving the shot will also increase blasts since these are basically white cells. there is no proof that this is true. I think people do get used living with low Hg but keep it above 8.0. Whites are a different thing as infection fears are great.

[Mary4Mike]

Jack,

Your analogy makes it more clear about the Neulasta/Neupogen. I have read different articles about the blast increase theory, let’s pray that doesn’t prove true.

Mike tries to stay at 9 or above for HGB. It gets too hard for him to breathe or do much when it is below that.

Thanks again,

[txnmomma]

Mary

Quote:

The literature says to have it within 24 hours of your last chemo treatment. He never received it that soon after

When my father had his rounds of Dacogen, he was given Neupogen within 24 hrs of the last dose. He would be admitted into the hospital and administered the Dacogen. When he was discharge they had him go back to the hosp the following day at the same time of the day he was discharged. Let’s say he was discharged at 2pm. He would go back to the hosp the following day at 2pm for the shot. They gave it to him for 7 days. I saw a slight change in the WCC. Nothing drastic, but his nader period was not bad at all.

Jack.. thats a good insight, never thought about it that way. Thanks!

My dad has weekly tranfusions. He goes in on Wednesdays for CBC’s. He is usually at 6.5 or so, so he gets 2-3 bags of blood and this boosts up to 8.0 or 8.1– but the following week, he is back down to 6.0 – 6.5

[txnmomma]

I do have to say that he only had 2 rounds of Dacogen. After the 2nd round, he really seemed to change.. and not for the good. He wasnt healthy enough to start a 3rd round. He has regressed ALOT!

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