Absolute neutrophil count (ANC)—ANC refers to the number of neutrophils present in the blood. Neutrophils are particularly important because they defend our bodies against certain types of infection.1
Anemia—Anemia is a lower-than-normal number of red cells in the blood. Red blood cells are important because they carry oxygen from the lungs to all other cells in the body. Shortness of breath, fatigue, and weakness are signs of anemia.2
Bacteria—The smallest forms of life. Bacteria are the most common causes of infections in people with cancer. Some examples of bacterial infection include food poisoning, pneumonia and strep throat.1
Chemotherapy—The use of drugs to destroy cancer cells. A person on chemotherapy may take one drug or a combination of drugs. Most often these drugs are given by vein using intravenous (IV) infusion. Some can be taken by mouth or given as a shot.2
Co-insurance—Some insurance coverage requires you to pay a percentage of the cost of covered medical services, usually 20–30 percent. Your portion of the cost is the co-insurance.3
Colony-stimulating factors—Also called CSFs, colony-stimulating factors are drugs that promote the production of various white blood cells. An example of a CSF is Neulasta® (pegfilgrastim).1
Complete blood count (CBC)—The CBC is a test that determines the number of red blood cells, white blood cells, and platelets in the blood.2
Co-payment—A flat fee for specified medical services required by some insurers. For example, your insurance provider may require you to pay a $10 co-payment for a doctor visit or a $50 co-payment for a hospital stay.3
Deductible—The amount you must pay each year for your medical expenses before your insurance policy starts paying. Deductibles are common in fee-for-service coverage and PPOs.3
Febrile neutropenia—Having a fever and a low white blood cell count (neutropenia). Febrile neutropenia is often a sign of a serious infection.4
Hematocrit (Hct)—A blood test that measures the number of red blood cells in the bloodstream. The lower the hematocrit, the lower the number of red blood cells in the blood. A person with a low hematocrit may have anemia. Hematocrit is sometimes written as Hct on CBC reports.5
Hemoglobin (Hb)—The part of the red blood cell that carries oxygen. A person with a low hemoglobin level may have anemia. Hemoglobin is sometimes written as Hb or Hgb on CBC reports.5
Infection—An invasion of microorganisms such as bacteria or viruses that have the ability to multiply and cause disease.1
Lymphoma—Cancer that begins in cells of the lymphatic system (part of the immune system that produces and stores cells that fight infection and disease).6
Myelosuppressive (sometimes called "strong")—Used to describe some chemotherapy, which can lower the number of blood cells in your body. Often, people use the word myelosuppressive to mean chemotherapy that lowers your number of white blood cells.5
Neutropenia—A lower-than-normal number of neutrophils (infection-fighting white blood cells) in the blood. It is a common side effect of some chemotherapy treatments. Doctors check the number of neutrophils when they measure the white blood cell count, to monitor the risk of infection.2
Neutrophil—The most common type of white blood cell. Neutrophils help the body fight infection. A low white blood cell count usually indicates that the neutrophil count is low. It is easier to get an infection and harder to recover from an infection when the number of neutrophils in the bloodstream is low.1
Oncologist—A doctor who specializes in the treatment of cancer.7
Placebo—Is a dummy treatment used in some clinical trials. In these studies, a group of patients who are given a placebo treatment are compared to another group of patients who are given the actual treatment. The difference in results between the actual treatment group and the placebo group are considered the result of giving the medicine.8
Platelets—A type of cell made in the bone marrow. The main function of platelets is to aid in clotting the blood following an injury.2
Side effect—Any undesired actions or effects of a drug or treatment. For example, common side effects of chemotherapy include fatigue, nausea, vomiting, and loss of appetite.2
Thrombocytopenia—A condition resulting from an abnormally low number of platelets (thrombocytes) circulating in the blood. Bleeding and/or bruising may occur if the platelet count is especially low.2
White blood cell (WBC)—A white blood cell is one of the three main types of blood cells. They are produced in the bone marrow and released into the blood. White blood cells are responsible for fighting infection. There are several kinds of white blood cells, including monocytes, lymphocytes, neutrophils, eosinophils, and basophils.1
Neulasta® (pegfilgrastim) is a prescription medication used to reduce the risk of infection (initially marked by fever) in patients with some tumors receiving strong chemotherapy that decreases the number of infection-fighting white blood cells.
Important Safety Information
Who should not take Neulasta® (pegfilgrastim)?
Do not take Neulasta® (pegfilgrastim) if you have had an allergic reaction to Neulasta® (pegfilgrastim) or to NEUPOGEN® (Filgrastim).
What should I tell my health care provider before taking Neulasta® (pegfilgrastim)?
If you have a sickle cell disorder, make sure your doctor knows about it before using Neulasta® (pegfilgrastim).
- Spleen Rupture. Your spleen may become enlarged and can rupture while taking Neulasta® (pegfilgrastim). A ruptured spleen can cause death. The spleen is located in the upper left section of your stomach area. Call your doctor right away if you have pain in the left upper stomach area or left shoulder tip area. This pain could mean your spleen is enlarged or ruptured.
- A serious lung problem called acute respiratory distress syndrome (ARDS). Call your doctor or seek emergency care right away if you have shortness of breath, trouble breathing, or a fast rate of breathing.
- Serious Allergic Reactions. Neulasta® (pegfilgrastim) can cause serious allergic reactions. These reactions can cause shortness of breath, wheezing, dizziness, swelling around the mouth or eyes, fast pulse, sweating, and hives. If you start to have any of these symptoms, call your doctor or seek emergency care right away. If you have an allergic reaction during the injection of Neulasta® (pegfilgrastim), stop the injection. Call your doctor right away.
- Sickle Cell Crises. You may have a serious sickle cell crisis if you have a sickle cell disorder and take Neulasta® (pegfilgrastim). Serious and sometimes fatal sickle cell crises can occur in patients with sickle cell disorders receiving Filgrastim, a medicine similar to Neulasta® (pegfilgrastim). Call your doctor right away if you have symptoms of sickle cell crisis such as pain or difficulty breathing.
What are the most common side effects of Neulasta® (pegfilgrastim)?
The most common side effect you may experience is aching in the bones and muscles. If this happens, it can usually be relieved with a nonaspirin pain reliever, such as acetaminophen.
- Occasionally pain and redness may occur at the injection site. If there is a lump, swelling, or bruising at the injection site that does not go away, talk to the doctor.
- Neulasta® (pegfilgrastim) should only be injected on the day the doctor has determined and should not be injected until approximately 24 hours after receiving chemotherapy.
- The needle cover on the single-use prefilled syringe contains dry natural rubber (latex), which should not be handled by persons sensitive to this substance.
If you have any questions about this information, be sure to discuss them with your doctor. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
- Infections in people with cancer. American Cancer Society website. Updated September 14, 2009. http://www.cancer.org/Treatment/TreatmentsandSideEffects/PhysicalSideEffects/InfectionsinPeoplewithCancer/infections-in-people-with-cancer. Accessed March 2, 2011.
- Chemotherapy and you. National Cancer Institute website. Update May 2007. NIH Publication No. 07-7156. Available at: http://www.cancer.gov/cancertopics/chemotherapy-and-you.pdf. Accessed March 2, 2011.
- New York State Department of Financial Services. Insurance Help: Health Insurance—Glossary of Terms. http://www.dfs.ny.gov/website1/inshelp/c_hterm.htm. Accessed April 12, 2012.
- NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines™): Myeloid Growth Factors (Version 1.2011). National Comprehensive Cancer Network, Inc. http://www.nccn.org. Accessed May 24, 2011.
- Chemotherapy principles: an in-depth discussion. American Cancer Society website. Updated September 28, 2010.
- Dictionary of cancer terms—definition of lymphoma. National Cancer Institute website. http://nci.nih.gov/dictionary?CdrID=45368. Accessed March 2, 2011.
- Dictionary of cancer terms—definition of oncologist. National Cancer Institute website. http://nci.nih.gov/dictionary?CdrID=46260. Accessed March 2, 2011.
- Dictionary of cancer terms—definition of placebo. National Cancer Institute website. http://nci.nih.gov/dictionary?CdrID=46688. Accessed March 2, 2011.