Is it advisable to wait for subsequent chemotherapy visits until there is a fever?

Question

Hello doctor,

I am an AML patient (leukemia), and two chemotherapies were done. Infection encountered twice already after each chemotherapy. I have dizziness, headache, and fatigue. Now opted out of chemo, and I am on supplements, but the latest blood report has very low neutrophil (9/mL of blood), and Hb is low too (7.8 g/dL). I have been advised by my oncologist to wait until I have a fever. Last time Peggrafeel was given when my WBC was low. Please advise.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

You have been diagnosed as having acute myeloid leukemia. Your attached CBC (complete blood count) report shows low hemoglobin and less WBC (white blood cell) count. Let me know when the WBC count and especially neutrophils are low because the chances of infection are present. Hence to prevent infection, prophylactic G-CSF (granulocyte colony-stimulating factors) can be prescribed. The drug you have mentioned is Pegfilgrastim which is a form of G-CSF. So in neutropenic patients, it can be given. But here, in your case, it is better to avoid Filgrastim therapy in my opinion, because this drug can stimulate the growth of cancerous cells. Even this drug can lead to allergic reactions in a few patients. So it is better for you to follow the oncologist's advice and not try to immediately start Filgrastim. Blood transfusion can be given in leukemia patients if symptoms are present and if it is necessary to increase Hb (hemoglobin) level. So consult your treating oncologist, discuss these things, and do regular follow-ups for your case.

Hope your concern is solved.

Take care.