For the three months that I was receiving Adriamycin, I also had to come in the day following each treatment to receive a Neulasta injection. Neulasta is a drug called pegfilgrastim.  

Some strong chemotherapy drugs also reduce your white blood cell count. This is why so many cancer patients get sick so easily while going through chemotherapy. These types of chemotherapy drugs are considered myelosuppressive, and usually results in a condition called neutropenia, which means there is a low white blood cell count. Neulasta is used to reduce the risk of infection in these patients.

Here’s some general information about chemotherapy and your blood: When going through chemotherapy, routine complete blood count (CBC) tests are done to check for the three main types of blood cells: white blood cells, red blood cells, and platelets. White blood cells protect the body against foreign invaders like bacteria. One specific white blood cell checked for is the neutrophils, which protects against infections. The test for neutrophils is the absolute neutrophil count (ANC). If your ANC falls below 1.8x109/L, then you may be diagnosed with neutropenia. Red blood cells use hemoglobin, or hb, to transport oxygen through the body. Hemoglobin also carries iron to your organs. The blood test for your actual red blood cell count is called a hematocrit, or hct. Healthy adult males should have an hct level of 42-52%; women should be at 37-47%. Levels lower than this mean you may have anemia, which usually makes you feel tired all the time. The body uses platelets to form clots and stop bleeding. A low platelet count is called thrombocytopenia. Individuals with this usually experience excessive bruising or bleeding. Healthy adults should have a platelet level of 150-400x109/L.

If you are at risk for neutropenia, your doctor may prescribe Neulasta for you. Other treatments are available for anemia and thrombocytopenia. Patients with sickle cell disorder should advise their doctor of their status before using Neulasta. If you are on Neulasta and have a sickle cell crisis after receiving the drug, tell your doctor immediately. If you have any questions, make sure to discuss them with your doctor. Also, tell the doctor if you are allergic to latex.

Patients should not use Neulasta if they have had an allergic reaction to Neulasta (pegfilgrastim) or Neupogen (filgrastim). 

Neulasta does have some side effects. The most common side effect is a deep aching in the bones and muscles that lasts for a two to three days. This can usually be relieved or eased with non-aspirin pain relievers like acetaminophen or ibuprofen. The follow side effects are common and are only cause for concern if they become severe or do not go away: bone, join, or muscle pain; constipation; headache; injection site bruising, lump, redness, or swelling; swelling in the ankles, feet, hands, or lower legs; vomiting; or weakness.  

More serious side effects that need to be reported to your doctor immediately include: dizziness; fast breathing; fever; hives; itching; pain in the upper left part of your stomach or the tip of your left shoulder; shortness of breath; rash; sweating; swelling around the eyes or mouth; trouble breathing; or wheezing.

If you notice any other unusual side effects after receiving Neulasta, call your doctor.

It is important to remember that, while Neulasta helps reduce the risk of infection, it doesn’t prevent them completely. If you notice symptoms of an infection such as chills, diarrhea, fever, rash, sore throat, or a cut or sore accompanied with redness, pain, or swelling, call your doctor.

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