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• About Low White
  Blood Cell Counts
  • Who is Most at Risk?
  • Understanding Your Blood Counts
• How Neulasta^®
  Can Help
  • Neulasta^® and NEUPOGEN^®
• Helping to Protect
  Against Infection
• Questions to Ask
  Your Doctor
• Support and
  Resources
  • Information on
    Neutropenia and
    Cancer
• Glossary of Terms
• Important Safety
  Information

Understanding Your Complete Blood Count

To take an active role in your chemotherapy plan, you should understand your blood counts and the actions you can take to help keep your counts up.

Complete blood count

A complete blood count (CBC)—sometimes referred to as your “numbers”—helps you and your doctor monitor some effects of your chemotherapy by measuring cells in your blood in relation to normal ranges.¹ “Normal” ranges provide a reference, but your doctor and nurse will evaluate your specific counts and work with you to determine if there are any problems to address.

A complete blood count measures amounts of 3 types of cells in your blood

• White Blood Cells (WBCs)
  WBCs help your body fight infection by protecting against foreign invaders such as bacteria and viruses. WBCs form a key part of your natural defenses, which are provided by your immune system. Neutrophils (NEW-truh-fils), a specific type of WBC, help protect against and fight infection¹. If your absolute neutrophil count (ANC) falls below normal, you have neutropenia. ANC is the typical measure of your body's ability to fight infection.²
• Red Blood Cells (RBCs)
  RBCs carry oxygen throughout your body, giving you energy and keeping your organs and tissues healthy.¹ Hemoglobin (HEE-moh-glow-bin), also known as Hb, is the protein that makes blood red. It contains iron and carries oxygen in your body.³ Hematocrit (hee-MAT-oh-crit), or Hct, is the percentage of red blood cells in the bloodstream.⁴ If your Hb or Hct level is too low, you may have anemia (ah-NEE-mee-ah), in which case you may feel tired and fatigued.¹
• Platelets (Plts)
  Platelets help your body stop bleeding by working with other blood factors to form a clot. A low platelet count, called thrombocytopenia (throm-boh-sy-toh-PEE-nee-ah), may lead to excessive bleeding or bruising.¹

Myelosuppressive chemotherapy can reduce the number of blood cells in your body, potentially disrupting your chemotherapy dose and schedule.⁴ The table below lists normal CBC ranges which can vary slightly between different laboratories that can test your blood.⁵ You can use this table as a reference when discussing your target blood count goals with your doctor. It's important for you to keep track of your blood counts.

	Track your blood counts against normal ranges*
					Normal Ranges - Male		Normal Ranges - Female
	White Blood Cells (WBC) Neutrophils (ANC) Red Blood Cells (RBC) Hemoglobin (Hb) Hematocrit (Hct) Platelets (Plt)				5,000-10,000/mm3 2,500-8,000/mm3 4.7-6.1 14-18 g/dL 42%-52% 150,000-400,000/mm3		5,000-10,000/mm3 2,000/mm3 and above 4.2-5.4 12-16 g/dL 37%-47% 150,000-400,000/mm3
					mm = millimeters    g/dL = grams per deciliter

* Normal ranges can vary slightly between different laboratories that can test your blood.

Indication

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^®?
Do not take Neulasta^® 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^®?
If you have a sickle cell disorder, make sure your doctor knows about it before using Neulasta^®.

What are possible serious side effects of Neulasta^®?

• Spleen Rupture. Your spleen may become enlarged and can rupture while taking Neulasta^®. 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^® 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^®, 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^®. Serious and sometimes fatal sickle cell crises can occur in patients with sickle cell disorders receiving Filgrastim, a medicine similar to Neulasta^®. 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^®?
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.

What important information do I need to know about receiving Neulasta^®?

• 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^® 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.

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