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Avatar universal

Temporarily stoping tx? Can that happen and work?

Well, today my husband received a call from the HCV nurse and was told that his white blood cells are dangerously low. He was told that he had to immediately stop all riba and shots.
He had to stop for a week a few weeks ago due to this.
He was sent to the phamacy to pick up an injection of "Neupogen" 300/mcg-ml
He's had such a rough time of this treatment, he's really weary of it all.  He seemed relieved that he was able to stop for awhile.  I'm concerned as I read so much about not skipping tx and being on time etc.
Has anyone taken Neupogen? Does it work fast and has anyone taken this drug and went back on tx shortly after?
*deep breath*  
8 Responses
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179856 tn?1333547362
Usually the neupogen is a very fast working medication and I do not understand why they insisted he stop treatment instead of taking the neup WITH the regular meds.  As a stage 3 it's critical that he get SVR now if possible - rather than later.

Many people in here have had their white blood problems repair themselves without even doing a rescue med. It would have seemed to me that staying on the peg and working out the other problems would have made more sense.

That is what most of us do.
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Avatar universal
also very happy to see Jim here

we are not doctors here, but Jim's advice is more accurate and up to date than the great majority of doctors

i had to take neupogen during tx and my ANC went up  very quickly. As I remember, it was by the next weekly blood test.
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181575 tn?1250198786
Sorry to intrude on the thread discussion, but just want to say hello to Jim.  Hi Jim.  I hope you are doing well. -Steven
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Avatar universal
Missing consecutive Peg injections can potentially serious compromise your husband's chances of SVR, especially given his slow viral response.

Related, is the question --  Was it really necessary to reduce to the Peg in the first place, as many inexperienced doctors pull (or reduce) the Peg much too early instead of either using more relaxed ANC (fraction of his white cells) guidelines, or starting Neupogen right away. Also, in many cases only the Peg is stopped (or reduced with low WBC and not the Riba.

All this, combined with some of your previous comments re your husband's medical team, beg for a second consultation ASAP with a liver specialist (hepatologist) and ideally not one affiliated with the same hospital as your treatment doctor.

Hopefully they will guide you on both the ANC/dose interruption issue, as well as whether your husband should stay on treatment and for how long. As a stage 3, you want to treat as agressively as reasonably possible, but at the same time you want to get a realistic evaluation of your husband's odds of SVR to best chart forward.

In any event, you should be asking for intermediate viral load tests to make sure the treatment interruptions haven't caused the virus to break through or surge, depending on whether he was UND previously.

All the best,

-- Jim
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Avatar universal
Thank you so much for your responses. I was admittedly a little nervous about him stoping tx for a few weeks.   Expecially since he took so long to respond.
:)
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Avatar universal
When I was on my second round of tx I had to quit all my meds twice for a week at a time. Adout a third of the way through I was put on neupogen shots that I had to take twice a week and  a couple of months later procrit shots that I had to take once a week. I am now SVR for 3 1/2 years
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104550 tn?1237913591
I've treated twice and was put on rescue drugs early both times. You are able to take Neupogen for the entire treatment if needed. I started taking Neupogen in week 6 and took 1 shot a week untill week 48. I also took Epogen starting week 20 untill week 48. I also stopped all meds twice and lowerd meds when needed to keep blood counts at a safe level.
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Avatar universal
Two wks ago I got the same call from my HCV nurse...she told me my WBC 1.4 and ANC .5  were to low so I had to take neupogen 480mcg 1/wk. She also told me not to take my INF for that week until my ANC went up some. I took my first shot of neupogen on a sat evening and had my cbc on wed.  My ANC and WBC went back up to a normal range after just one shot so it does work fast. I did take my INF as usual on the following friday 4/4/08. I've taken one more shot of neupogen and if my anc stays up there I wont' have to take it anymore.  Whoo! Hoo!  One a wk is enough for me.

I hope you the best....Darla
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