Overview of Neutropenia and Infection

	How neutropenia can affect your successful chemotherapy Neutropenia (new-tro-pee-nee-uh) is the medical word for low white blood cell count. It can be a very serious condition, because white blood cells protect your body from infections. Without enough white blood cells to protect you, even a small infected cut could become life-threatening.
Your doctor checks to see if you have neutropenia every time you get a blood test. If you are neutropenic, every precaution will be taken to avoid infection, even if no signs of infection are present. Your doctor may prescribe NEUPOGEN® (Filgrastim), a treatment that stimulates your body to produce more white blood cells. Even with a medication like NEUPOGEN® there may be times when chemotherapy will have to be reduced or delayed until your white blood cell count returns to normal levels. This delay is to be avoided if possible. Research has shown that with some tumor types, getting the prescribed dose of chemotherapy on time, every time, is important to the chances of an improved survival.^1,2,3 It is for this very reason that some doctors prescribe NEUPOGEN® at the start of chemotherapy, as a preventative step against the complications of neutropenia. Regardless of when your doctor prescribes NEUPOGEN® for you, you should talk to him/her about continuing to take it after each subsequent chemotherapy cycle, because once you experience a low white blood cell count, you are much more likely to experience it again.⁴ It's important to note that NEUPOGEN® does not eliminate the risk of infection entirely. What it does is minimize your risk. Always be on the alert for the common signs of infection, such as fever, chills, sore throat, rash, diarrhea, or redness, swelling, or pain around a wound or sore. If you experience any of these, call your doctor or nurse immediately. NEUPOGEN® (filgrastim) is indicated to decrease the incidence of infection, as manifested by febrile neutropenia, in patients with nonmyeloid malignancies receiving myelosuppressive anticancer drugs associated with a significant incidence of severe neutropenia with fever. With NEUPOGEN®, as with any medication, you may experience some side effects. In a large study with 207 patients receiving NEUPOGEN® therapy following combination chemotherapy, bone pain was reported in 22% of patients. In most cases, bone pain was controlled with non-narcotic analgesics such as acetaminophen. ¹ Bonadonna G, Valagussa P, Moliterni A, Zambetti M, Brambilla C. Adjuvant cyclophosphamide, methotrexate, and fluorouracil in node-positive breast cancer: the results of 20 years of follow-up. N Engl J Med. 1995;332:901-906. ² Budman DR, Berry DA, Cirrincione CT, et al. Dose and dose intensity as determinants of outcome in the adjuvant treatment of breast cancer. The Cancer and Leukemia Group B. Natl Cancer Inst. 1998; 90:1205-1211. ³ Wood WC, Budman DR, Korzun AH, et al. Dose and dose intensity of adjuvant chemotherapy for stage II, node-positive breast carcinoma. N Engl J Med. 1994;330:1253-1259. ⁴ Silber JH, Fridman M, DiPaolo RS, et al. First-cycle blood counts and subsequent neutropenia, dose reduction, or delay in early-stage breast cancer therapy. J Clin Oncol. 1998:16:2392-2400.