Talk With Your Doctor Before
Starting Strong Chemotherapy
Talk with your doctor about your possible infection risk before starting your chemotherapy. If you’ll be receiving strong chemotherapy, your doctor may prescribe a white blood cell booster, such as Neulasta®.1 Your doctor may prescribe Neulasta® starting with your first cycle of chemo and with every cycle, including your last. In a key clinical study, a low white blood cell count with fever—also called a neutropenic fever or febrile neutropenia—happened through all cycles of chemo, but happened most often in the first cycle of chemo.2
Understand your risk of infection
If you are on strong chemotherapy, you may have a greater chance of developing a low white blood cell count or infection if any of the following apply to you:
- You are 65 or older.3
- You previously developed a low white blood cell count while being treated with strong chemo.3
- You already have a low white blood cell count while being treated with strong chemo.3
- Your cancer has spread to your bone marrow.3
- You've had strong chemotherapy or radiation before.4
- You have medical conditions like diabetes, liver or heart diseases.4
- You have late stage or stage 4 cancer.4
Questions to ask your doctor about infection risk with
The questions below can help you start a discussion with your doctor about low white blood counts and risk of infection. You may find it helpful to print out these questions and take them with you on your next visit.
- Which people on strong chemotherapy have an increased risk of developing neutropenia and infections?
- Why does some chemotherapy increase my risk of infection?
- What effect can a low white blood cell count or an infection have on me?
- What are blood counts?
- How are blood counts measured?
- Should I keep track of my blood counts during chemotherapy?
- How can I keep track of my blood counts?
- What happens if I get a neutropenic fever?
Print these and other questions and take them to your next appointment.
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- Neulasta® (pegfilgrastim) Prescribing Information, Amgen.
- Vogel CL, Wojtukiewicz MZ, Carroll RR, et al. J Clin Oncol. 2005;23:1178-1184.
- Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Myeloid Growth Factors V.2.2014 © National Comprehensive Cancer Network, Inc 2014. All rights reserved. Accessed May 27, 2014. To view the most recent and complete version of the guideline, go online to NCCN.org. NATIONAL COMPREHENSIVE CANCER NETWORK®, NCCN®, NCCN GUIDELINES®, and all otherNCCN Content are trademarks owned by the National Comprehensive Cancer Network, Inc.
- Lyman G H. JNCCN. 2005;3:557–571.