How to increase Leukocytes between chemo therapies - 1252227

Sat, 01/05/2013 - 08:37

Dear All,

I need your advice and help for the second time. My mother has ovarian cancer, she had surgery and now she is going on chemotherapy. She had finished second chemotherapy, but her Leukocytes are low. She goes to the mountain almost every day and walks for one hour, we know that helps. But that's not enough obviously.

How can she increase her Leukocytes?

Thank you All very much.


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Dr. Walko has written a blog on the subject here,…
She explains, "When the white blood cell count is low (usually less than 500), the risk for infections increases significantly. "
She goes on the say,
"The most commonly used growth factor in patients receiving chemotherapy is G-CSF, also known as Neupogen (filgrastim). Neupogen is given as a subcutaneous (under the skin) injection daily following chemotherapy to boost the white blood cells in patients who are at risk for having a low white blood cell count for a longer period of time. When the white blood cell count is low (usually less than 500), the risk for infections increases significantly. Giving a drug like Neupogen will shorten the time the white blood cell count is low and help the cells not decrease in number as much. White blood cells have a very short life span and thus fall quickly but also recover quickly. Neulasta or pegfilgrastim was approved in 2002 and is the same drug as Neupogen but has a molecule called polyethylene glycol (PEG) attached to it. This allows the drug to last longer in the body and can be given as a one time dose after chemotherapy rather than daily dosing like Neupogen. Both Neupogen and Neulasta are used to prevent neutropenic fever in patient receiving chemotherapy who are at high risk of developing neutropenic fever based on risk factors such as older age, medical history, and degree to which the chemotherapy causes a decrease in the white blood cells. In general, if a chemotherapy regimen has shown to cause neutropenic fever in at least 20% of patients, then Neupogen or Neulasta should be started with the first cycle of chemotherapy to prevent neutropenic fever (primary prophylaxis). The drugs are also used in patients receiving chemotherapy who had a neutropenic fever episode on a previous chemotherapy cycle (secondary prophylaxis)."


I understand this isn't answering your question but here is a conversation about low white blood counts that may be helpful. I just don't think there is anything outside skipping treatment or taking a drug like neulasta to combat this chemo related problem.

I know this is a common question and there is much written. You may want to do a search on it yourself to really find the specifics you're looking for. Note that you may need to log off to get search results, there is a problem between some explorer browsers and our parent site.

Don't hesitate to ask when you need help,

Dr West

Janine's answers are really spot on. The two main variables are time off of chemo (or reducing chemo dose) and adding growth factors like G-CSF (also known as Neupogen, or filgrastim) or a "depot", longer-lasting version of that (Neulasta, or peg-filgrastim) that can be given after chemo (preferably starting a day after the last chemo in a cycle has been administered).

Good luck!

-Dr. West