• 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

Who's Most at Risk for a Low White Blood Cell Count?

Some patients who are receiving strong chemotherapy (also referred to as myelosuppressive chemotherapy) can develop low white blood cell counts during treatment. This condition of low white blood cell counts, called neutropenia, can increase a patient’s risk for serious infections.^1-3 The risk of developing an infection increases the longer the patient has low white blood cell counts.⁴

Studies have shown that if you are a patient treated with strong chemotherapy, you may be at even greater risk of developing low white blood cell counts or infection if you have any of the following:^1-3

• You are 65 years or older.
• You have previously been treated with strong chemotherapy or radiation.
• You have other medical conditions (such as diabetes and liver, heart, or lung diseases).
• You have advanced cancer.
• You have open wounds or an already active tissue infection.
• You previously developed low white blood cell counts while being treated with chemotherapy.

In patients with low white blood cell counts, fever can be a sign of infection. Patients who come to the clinic with fever and low white blood cell counts (also known as febrile neutropenia) are, therefore, treated as if they have infections.⁵ Although patients can develop fever with neutropenia in any cycle, many studies have found that the risk of developing febrile neutropenia is highest after the first cycle of chemotherapy treatment. In a study of patients with cancer who were receiving strong chemotherapy, more than half of the cases of neutropenia with fever, otherwise known as febrile neutropenia, occurred in the first cycle of chemotherapy.⁶

In a study of cancer patients, more than half of febrile neutropenia cases occurred in the first cycle of chemotherapy.⁶

You may want to talk with your doctor about your potential need to address your white blood cells count. Your doctor is the one who best understands your individual situation and how to manage it.

In addition to learning about your risk, it may help to understand your blood counts.

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^®.

• 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.

• 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.

Next: Understanding Your Blood Counts >>