My father is on R-Chop and about to get his 4 cycle. After last cycle his WBC count was close to zero and he was admitted to the hospital. Is this normal and what can we can to keep it little hig next time plus he is receiving long lasting shot to boost his WBC count. Please advise. We don't want to change the chemo because it is responding to Lymphoma.
Lymphoma and low white blood cells.?
This is unfortunate but common. His long-acting shot is presumably Neulasta, which does help the WBCs recover faster, though they can still drop just as low. The risk for infection is related to the duration of low white count and how low it actually goes.
If a patient is already on growth factor shots and still gets a neutropenic (low white count) fever requiring hospitalization/antibiotics, the usual maneuver is to dose reduce the CHO (not the P and R) by 20-25%. This still provides effective doses, and reduces the risks of infection complications. An alternative is to provide continuous coverage of antibiotics during the course of therapy, keeping the chemo dose the same. I generally don't favor this, but your doctor might for various reasons (meaning I have done it, but it is not my pattern).
God bless, best wishes
wallflower
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